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" 



EDWARD II KIRSCHBAUM BCX)K n ND 

YALE MEDICAL l.lhRARY 




'' A.n r ^- f/Hc r ,<„, 



9C 



THE 

SURGICAL HISTORY 



OF THE 



NAVAL WAR BETWEEN JAPAN & CHINA 



DURIXii 



1894-95. 



TRANSLATED 
FEOM THE ORIGINAL JAPANESE REPORT, 

UNDER THE DIRECTION OF 

Baron Y. SANEYOSHI, 

P. R. c. S. Eno. etc.. Director Gknkrai, of Mrdii u. Department of imperial Japanese Navy, 

BY 

S. SUZUKI, 

11. R. C. s. Eno. l. R. C. p. Lond. etc., Deputy inspector general of Hospitals and Fleets, 

Imperial Japanese Navy. 



TOKIO: 

PRINTED BY TOKIO PRINTING CO., LTD. 

1900. 



THIS BOOK IS SOT FOH 






PREFACE. 

We consider it our duty to the Medical Profession to publish 
the accompanying record of casualties in the war between China and 
Japan (July 1894 — November 1895). Much has been written about 
the wounds received in wars on land, indeed the Medical and Surgical 
History of the American Civil War is full of interest and information. 
Of naval warfare we possess no medical history : the lessons of 
Trafalgar and Lissa, and war between Chile and Peru have been lost 
to us, and there has been no previous experience of the treatment of 
the wounded on ships since the modern revolution in naval warfare. 

Our ships were, as a rule, considerably injured in the battle of 
the Yellow .Sea, 17 Sept. 189-1, and our surgeons during and after that 
battle were so busily occupied with the treatment of the wounded that 
they found little time for keeping accurate clinical records. However, 
in June LS95, a circular was issued by the Naval Department to the 
surgeons in charge of Ships and Naval Barracks asking for detailed 
replies to a carefully elaborated set of questions as to wounds, diseases 
and genera] sanitary conditions during the war. 

In addition to the replies thus obtained from our surgeons we 
have used the following documents in the compilation of this book: 

Sick Lists. Daily Sick- Reports. 

Clinical Records. Monthly Sick-Reports. 

-\r ,i i p . ,■ r Quarterly Reports of Clinical 

Monthlv Reports of borce. v ,-, J . ^ 

" ' LxiMirience. 

Billets ot \\ ounded. Certificates of Wounded. 

Certificates of Death. Periodical Reports of Observa- 

Reports on the Effects of Shells tions made by our Surgeons. 
received Occasional Reports of Observa- 

tions made by our Surgeons. 

June, 1900. 



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in 2011 with funding from 

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CON T E N T S 



CHAPTER I. 

BATTLES AND INJURIES 

1. THE NAVAL BATTLE AT PHUNG-DO .. 

2. THE BATTLE OF YALU" 

3. THE BOMBARDMENTS OF TANGCHOW. 

4. THE ATTACK ON WEI-HAI-WEI 

5. THE STORMING OF THE PESCADORES 

6. BOMBARDMENTS AT OTHER PLACES .. 



PAGK 

1 
1 

2 

47 
47 
59 
60 



CHAPTER U. 



BRIEF HISTORY OF THE KILLED AND WOUNDED ... • 

1. INJURIES EXTENDING OVER THE WHOLE BODY . 

2. INJURIES OF THE HEAD 

Injuries of the Scalp 

Injuries of the head accompanying the fracture or cerebral lesions 

3. INJURIES OF THE FACE 

Injuries to the soft parts 

Wounds of the face with fracture 

Injuries of the eye 

Injuries of the ear 

4. INJURIES OF THE NECK 

Injuries of the skin and superficial muscles 
Injuries of the deep parts 

5. INJURIES OF THE CHEST AND BACK 

Injuries of the chest wall 

Wounds of the thoracic cavity 

0. INJURIES OF THE ABDOMINAL AND LUMBAR REGIONS 

Injuries of the abdominal walls 

Penetrating and perforated wounds of abdominal cavity 
7. INJURIES OF THE UPPER EXTREMITY 

Injuries of the shoulder 

Wounds of the shoulder joint 

Injuries of the arm 

Injuries of the elbow joint 

Injuries of the fore-arm ■ 



61 
61 
63 

03 

09 

79 

79 

80 

93 

100 

104 

104 

105 

106 

100 

112 

110 

116 

120 

130 

130 

135 

130 

145 

146 



j v COXTES 3 

• 

i t.u baud loH 

Injuries of the finger 158 

>. [NJURIES OF THE LOWER EXTREMITY 164 

Injuries of the gluteal and inguinal regions 164 

Injuries of the thigb l |i,; 

Injuries of tbe knee ITT 

if the leg l s l 

Injuries of the ankle joint 193 

Injuries of tbe foot 196 

Injuries of tbe toes 200 

0. BURNS 201 

Burns of tbe whole body, and of tbe greater part of tbe body 201 

Burns of various parts 208 

Burns of local part 218 

10. SCALD 220 

11. FROST-BITE 222 

12. DROWNING 224 

CHAPTER III. 

STATISTICS OF INJURIES 225 

1 ON THE BATTLE OF THE YELLOW SEA 225 

leNo. 1 Number of killed and I arranged according to vessels 226 
No ■! Number of killed & injured classified according to ranks | A 2-JT 
Table No 8 do. do. do. do. (B) 228 
Table No. 4 -Showing tl of the lulled aud wounded to the num- 
ber of shi 280 

Table N". 5 -Classification of the places struck by shells in each vessel 
Tabli No 6 Number of the killed and wounded in each vessel arrang- 

iccording to place 284 

Tabic No. 7 Wounds arranged according to locality 286 

Tab! No. 8 tiou ol injuries arranged according to their 

termination 240 

. bicb ended fatally 246 

2 01 ATTACK ON WEI-HAI-WEI 251 

in Killed aud wonuded arrauged according t" vessels ... 251 
1 1 Killed aud woundi '1 nrrangi • ! according to ranks in i 

253 

I ' Killed and wounded ai ...264 

!:: Ratio of the killed and wonuded to the number of sli 



I i Pla els bit In 257 



CONTEXTS V 

Pag 

Table No. 15 — Parts of each vessel where casualty occurred 258 

Table No. 16 — Classification of injuries arranged according to locality.. 259 
Table No. 17 — Classification of every wound as an independent one ... 261 

Table No. 18 — -Termination of wounds in respective localities 262 

Table No. 19 — Classification of mortal wounds 264 

Table No. 20 — Course of the wounds 265 

Table No. 21 — Results of treatment of the wounds both in the battles 

of the Yellow Sea and Wei-hai-wei -G- J 



CHAPTER IV. 

CAUSES OF WOUNDS AND THEIR CLASSIFICATION 268 

1. CONTUSION •• 2 72 

Contusion caused by shell fragments 272 

Contusion caused by metallic fragments 2*4 

Contusion caused by wooden splinters 275 

Contusion caused by the shock of shell explosion 276 

Contusion owing to compression or falling - J '° 

Contusion of uncertain cause - 1 ' " 

2. ABBASED WOUNDS— GUTTER WOUNDS— WOUNDS ATTENDED 

WITH LOSS OF SOFT TISSUES 281 

Abrased wound caused by shell-fragments 282 

Abrased wound caused by iron-pieces 282 

Abrased wound caused by wooden splinters 282 

Aliased wound due to other causes 

Gutter wounds '■" L ' i 

Wound attended w itli loss of soft tissues -°° 

3. CONTUSED WOUND 287 

Contused wound caused by shell-fragments 287 

„ .. .. ,, iron-pieces -* 70 

„ .. .. wooden splinters 296 

Contused wound caused in the neighborhood of shell explosion •-i'- ,;i 

Contused wound of uncertain cause ^ ( -' 1 

Contused wound due to fall :Tiul 

„ „ ,, compression or collision ^ <J '- J 

4. BLIND WOUND AND PENETRATING WOUNDS 304 

Blind and penetrating wounds caused by shell fragmeuts 304 

n ,, ,, iron-pieces 

Blind wound caused by w leu splinters 

Blind wound of uncertain cause 

Blind wound caused by husk of buck-wheat 331 



324 

... 327 
... 329 



VI 



- 



Blind wonnd caused by ballet 

PERFORATED WOUND 

I wonnd cansed by an entire shell 

■ • shell-fragments 

.. iron-pieces 

bullet 

LACERATED AND MUTILATED WOUNDS 

I wound cansed by an entire shell 

,. shell-fragments 

.. iron-pieces 

in the neighborhood of shell explosion 

of uncertain cause 

caused bj -ion 

.Mutilated wound 

BURNS AND SCALDS 

Burns 

S ilds 

RUPTURE OF TYMPANIC MEMBRANE 



Pas* 
381 
338 
888 
334 
847 

352 
858 
854 
854 
355 
356 
356 
857 
867 
867 
878 
374 



< iiaitki; V 



COMPLICATIONS OF WOUNDS 

1. HEMORRHAGE 

Primary bsemorrhage 
mdary btemorrbagi 
2 NERVOUS SYMPTOMS . 

Shock 

Traumatic delirium 

Paralytic insanity 



- PPURATION 

i GANGRENE 

ERYSIPELAS 



875 

375 
875 

882 
383 
388 
38C 
380 
387 
388 
393 



("HAPTEN VI. 



MANAGEMENT OF THE WOUNDED 
i SURGERY IN MIL SHIP 

m| i |||. Will \|,| |. 

. i:l.\'l i; i in. wni SDS 



i"l 

I 02 



LIST OF ILLUSTEATIOXS. 



Penetrating wound of the Cranium— Showing External surface of a piece r,f the 
frontal bone removed by trephining — internal surfac -.me. 

• rating wound of the face with fracture of the nasal lx>nes. 

Penetrating wound of the thorax and abdomen with fracture of the ribs. 

Wound of en] de sac of the right upper arm with fracture of the humerus and 
several wounds of other parts. 

Perforating wounds of both arms with fr humerus, and penetrating 

wound of the rib. 

Figure of artificial aim given by Her Ma :' Japan. 

Perforating wound of the right thigh. 

Perforating wonnd of the right thig aur. 

Piece of stanchion extracted from the ;bt I . showing both surfa< 

Figure of artificial leg given by Her 11 the Empress of Japan. 

Penetrating wound of the right . i ; wound- 

face. 

Perforating wound in the soft tiss I the right 

Perforating wound in the soft 

Contused wound of the right leg showing tb 

Burns caused by the explosion of gun-powder. 

Appearance of the same patient after recovery. 

Burns caused by the explosion of ammunition. 

Keloid cicatrices after the recovery of bums in the same patient. 
re of the fore part on the low. '. 

xplosion of a shell. 

Figure of the lower deck of til ~: showing the explosion of a shell in I 

surgery (the wardroom). 



EEKATA. 

Pagb 7". hue 22, for •• 13th " read " 30tli 
.. 120, line 12, for " perforated wound" read " penetrating am 
perforated wounds. 
161, line 2, for " be " read " lie." 

200, line 15, for " epdinrieis " read " epidermis 
272j line 16, for "c ratused wounds" read "contusions." 

201, lino 2", for " contusion " /"i./ " contused wound " 
311, line 13, for " penetrating " read " perforating." 



INTRODUCTION. 

In the Japan-China War during L894 — 5, the naval battles of 
Phung-do and V;iln, the attacks of the Japanese upon Tangchow, 
Wei-hai-wei, the Pescadores, and those upon Keelung, Takau, and 
Anping in Formosa were the principal engagements ; our bom- 
bardments of Hwa-yuan-kow, Talien-Bay, Port Arthur, and Ying- 
ching Pav may he also reckoned as sea-fights of importance. The 
description of the general conditions of the war, that is, the force and 
movements of our squadron and those of the Chinese Meet &c, 
naturally belong to other public documents, and do not come within 
the scope of this history. Only a few remarks will he made there- 
fore, with regard to the general engagements themselves: the condi- 
tiou of the killed and wounded in the various actions will alone 
he fully described in the following chapters. 



THE SURGICAL HISTORY OF THE NAVAL WAR 
BETWEEN JAPAN AND CHINA. 

CHAPTER I. 

BATTLES AND INJURIES. 

l.-THE NAVAL BATTLE AT PHUNG-DO. 

On the 25th of July. L894, our First Flying Squadron consist- 
ing of the men-of-war Yoshino, Naniwa, and Akiteushima fought 
against the Tsi-Yuen, Kwang-yi, Tsao-kiang, and a transport of the 
Chinese fleet on the sea of Phung-do. This was the first naval battle 
fought between the two nations, and our squadron defeated the 
enemy's fleet at one stroke. 

During this action, a shell discharged from the Chinese 
fleet struck the Yoshino on her starboard at '.> o'clock a.m., crushed 
the middle part of the fore gaff (about 20 metres above the sea Level) 
ami passed (iff toward the port side. 

At half-past 9, a 1 ."> centimetre shell discharged from the Tsi- 
Yuen. perforated the fore part of the left side of a pinnace situated on 
the middle booms, (about 7 metres above the sen level), it also 
destroyed a boat and timbers placed on the deck-house : then it passed 
downward perforating the ceiling of the dynamo-room in the middle 
of the upper deck, and broke the left end of a cylinder in that room : 
then, after striking the left part of the back wall of the room, it fell 
into the engine room, where it slopped without exploding. No one 
was either killed or injured by it. 

At half-past 7. a shell of about 1- centimetres perforated the after 
part of the port side of the Naniwa, at a point about 1.6 metres above 
the sea level, destroying the officer's scullery, a beam, ami a deck- 



2 I HI. HA I I I.K OF YAL.C. 

iger ; then penetrating then scullery of the guii room, and the 
etweeu the lieutenant rooms, passed forwards and upwards, 
perforating the steel-deck at the left side of the after battery : al this 
ii destroyed an arm of a kedge-anchor, a derrick, i rior 

w.i 1 1 of a magazine below the after bridge, and a morning hos 
and finally passed away without bursting, do one being killed or 
injured by it. 

ring this battle, three men of the Yoshino had their membrana 
tympani perforated by the vibration of air caused by the discharge of 
their gun. Three men of the Naniwa received slighl burns from the 
produced by the discharge of their gun. 

2. THE BATTLE OF YALU. 

Ii was on the 17th of September, 1894, thai the Japanese Com- 
bined Squadron composed of the Principal Squadron which compr 
the Matsushima, Itsukushima, tiashi lat . Fuso, Chiyoda and Hiyei : 
the Firs! Flying Squadron comprising the i oshino, Naniwa. Takachiho, 
A.kitsushima, and the gun-boat A.kagi, with the ex-merchant steamer 
Saikyo-maru transformed into a cruiser for the time beii it a 

decisive battle on the Haiya gainst the Chinese fleet, consisting 

of the Ting Yuen, Chen Yuen, King Yuen, Lai Yuen, Ching 
Yuen. Chih Yuen, Ping Yuen, Tsi Yuen, "i 3 W< . Chao 
Yang, Kwang Chia, Kwan Ping, and a few torpedo-boats. I 
battle commenced at 12.50 p.m. an md hotter until the 

dim i'een _ p.m. and 3 p.m. By that time mosl of 

the Heel had been either sunk or burned under 

"iir furi i 1 1 ■• -i 1 1 and \ linder had n o a |)lac 

"J ... - i], of our Squadron i 

in <-n in the follow le. 



THE BATTLE "F YAH". 





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nn: BA i ii. 1: OF \ u r 



In this battle our warships received more than one hundred 
shells in various parts, :m<! two hundred and ninety eight persons 
were either killed or injured. A naval battle is a very formidable 
thin"-, much more so than n land fight ; for il consists of either firing 
bi<r guns, ramming, or the discharge of fish-torpedoes, by which a 
whole ship may suddenly be destroyed or sunk, even when ii i- 
simply hit by shells without exploding. Ship.-' planks, furniture &c, 
are destroyed, and many lives are lost, or injuries sustained from the 
living splinters. When the shells explode, fearful damage ivsiilts. 
Occasionally .-hips hit by shells escape without injury to life, but this 
depends upon the part of the ship- hit. In this battle our ships 
fortunate!} escaped total destruction though the damage done to each 
-hip was severe, especially on the Matsushima where the bursting 
of a shell caused the explosion of the ammunition. 

The following table shows the number of shells which hit our 
ships and the number of killed and wounded. 



Ships. 


Shells 


Kn.i 


In .ii 


i . i . 

D LND 










. ... 


13 


3-5 


7.s 


1 i 


[tsukushima 


8 


13 


Is 


.1 


[lashidate 


II 


:; 


10 


13 


Fusu 


8 


2 


12 


1 l 


Chiyoila 

Hi. 

\< i-hni i 


3 
23 

8 


iVl 

1 


II 


56 
12 




:i 




• i 


• ) 


Takachiho 


5 


1 


• > 


3 


Akn sushima 


1 


.". 


In 


15 




30 


1 1 


17 


28 


SnikyO n in rn 


12 




II 


11 


l - ... I'M 


'.i< i 







F " killed " in thii tnlde ill I 1 ii liatelj It i« the sauio 

I'll.- i lie marked dim ■ . « Inch 

I i . - 1 1 slight 



THE BATTLE OF YALT 5 

The details of the coarse of shells, of the damages sustained by 
the ships, ami of deaths or injuries among the ships companies 
mentioned in the above table will lie fully described in the 
following articles. 

The MatsUShima. 1.— At 12.55 p.m., a shell of about 
15 cm. hit the upper border of the turret of the 32 cm. gun on 
the after part oi the upper deck and exploded ; a part of its fragments 
destroyed the after-wall of the captain's cabin, and the search-light, 
other pieces entered into the turret, tore the hydraulic tube and crush- 
ed the rails on the turret, the splinters of the rails cut off five signal 
halyards and wounded a man. At this moment Commander >S. Muko- 
yama on the after bridge was wounded slightly by a piece of the shell. 

2. — At 1.20 p.m. a shell of about 15 cm. exploded against 
the gun-mounting of the starboard seventh Hotchkiss' light quick- 
firing gun, (7.8 metres above the sea level) in the middle part of the 
flying deck and carried off the gun and shield ; the fragments of 
the shell, and gun-mounting tore the deck and destroyed the search- 
light of the after part, the lower portion of the main mast, and the 
skv-li^'hts. I5v these fragments two men of the Hotchkiss' were 
killed and two were wounded. 

."!. — At 1.25 p.m.. a 47 millimetre shell 'perforated, at a point of 4 
metres above the sea level, the lavatory of the admiral's cabin which 
stands on the starboard side oi the lower deck at the stern, and passing 
obliquely through the flag-captain's cabin, destroyed the chest before 
the cabin, and fell near the entrance ot the after magazine. As it did 
not explode, no casualty occurred. About the same time, flag Lieute- 
nant Shimamura who was on the fore bridge received a slight injury 
from a small piece of shell. 

4. — At 2.30 p.m., a shell of about 15 centimetres perforated the 
right side of the funnel at a point of 10.5 metres above 'sea level. 



! UK BATTLE OF YALu". 

At 2.34 p.m., ii 26 centimetre ^liell discharged from the Ping 
Yuen perforated, m ;i point of 3.G metres above the sea level, the 
mess-room on the porl side ol the middle pari of the lower 'leek 
where the surgeons were stationed, destroying more than hall 

medicinal articles ; then the shell perforated the torpedo magazine 
ami passing beueath the torpedo discharger, crushed the side plate al 
the entrance to the engine room. Lastly i I struck againsl the <jun- 
mounting of the 32 centimetres and tore ii to pieces (withoul explod- 

_. damaging - . oil-tanks, and medicine-chests. By the scat 
ing of the fragments <>f the iron ['late, the beams above the 
torpedo-discharger, the rails for the torpedo, a fish-torpedo (a pari "I 
the body being perforated withoul explosion), the scullery, lavatory, 
bath mo in. a pari "1' the gun-room water-closet, and the surrounding 
parts ni the lower deck were destroyed. Ai this time, Sub-Lieutenant 
A. [de wlio was directing tli*- torpedo was thrown down by the pass- 
ing force of the shell; he was also injured by a piece of tin- iron 
plate, three <>t the torpedo crew were killed by the shell, and four 
men were more or less wounded by the iron and wooden splinters. 

15. — At 2.42 p.m., a 37 millimetre shell perforated the engineer's 
room on the porl side of the middle pari of the lower deck, al a poinl 
of 4.5 metres above the sea level, and exploded againsl the mount 
of the 32 centimetre gun, bul no marked damage was sustained. 

7. Ai ."..In p.m., it -17 millimetre shell perforated the torpedo- 
chamber on tli<- porl side of the middle pari ol the lower deck, and 
exploded againsl the shell-mounting under the main mast. At this 
time-, a lorj)edo man was severely wounded. 

v — At 3.2(i p.m., i v. 1.5 centimetre shells simultaneously 
struck al a pant of abnul 4.5 metres above ili<- sea level, No. I l"i 

"t 12 centimetre gun on the porl side of the fore pari of the lower 
I • ot e struck the gun obliquely anil changed its direction a 



THE BATTLE OF YALU 7 

little upwards, perforated the upper deck on the starboard .side and 
passed through the netting on the same side. The other one explod- 
ed against the shield, igniting the ammunition placed around the 12 
cm. guns on each side, especially that which was piled up at the 
entrance of the magazine. These explosions smashed gun gears, 
trunks, chests, etc. and caused a fire among the fragments of wood 
and canvas which were scattered about. The shell then destroyed 
electric cells, and wires, and the ladder in the fore torpedo-chamber ; 
it also broke the iron-cover ofasheel chain locker under the ladder, 
and depressed the doors of the lockers on both sides of the torpedo- 
chamber, and damaged their contents. As the lower deck upon both 
sides of the water-tank was destroyed and fell on the tank, more than 
half the wash tubs arranged on it, and the windlass were destroyed ; 
the ladder of forward hatch No. 1 was blown oft"; the steam pipe and 
voice tube were cut off, while the iron plates surrounding the entrance 
of the fore-boiler were depressed. Further, the gun-room and opposite 
mess-room were damaged in several places, and cracks and irregularities 
were produced on (lie upper and lower decks forwards, especially on 
the starboard side of the upper deck. The warrant officers' room, 
their bed rooms and bath room were also destroyed by the bursting of 
a shell, the sick berths in the fore-part of upper deck being damaged, 
and the medical stock provided there almost entirely destroyed. 
Moreover the forward search lights were destroyed and the forecastle 
and adjacent parts greatly damaged. 

During this engagement, many officers and men on board the 
Mafsushima were either killed or injured, some by the fragments of 
the enemies' shells, some by the explosions of our own gunpowder, 
some by splinters of ship's planks and tools. In this way thirty 
persons were killed on the spot while seventy persons were 
wounded. 



THE BATTLE OF 'i Ml" 



Peksons Killed on nn. Sk>t: 



In the neighbourhood of tin- fore battery <>l the lower deck ; 
Lieutenant K. Sbima. 
Sub-Lieutenaul M. [to. 
First class [jetty officer ^ . Shigeta. 

Ai tbe starboard battery oftbe fore pari on the lower deck; 
Ten men ; and, at tbe [)orl battery, four men. 

I nder X". 1 liatch on the fore pari of the lower deck ; 

Two baud men stationed there ;i- ambulance men. 

Near tbe magazine <>n tbe fore part of the lower deck ; 
< 'in- seaman. 

At the entrance of the magazine on t lie fore pari of the lower 
deck ; 

Eighl seamen, acting :i^ ammunition suppliers. 

I'wo seamen were killed by a violent shock of explosion while 
undergoing surgical treatment in the temporal'}' surgery <>n 
tbe fore pari of the upper deck. 



Pi [{SONS Ivu KIP : 

Near tbe fore batter) on the fore pari "l the lower d< 

Midshipman l\. ' bshi. 
Ai tlie porl battery on tbe fore purl oftbe lower dei 

Sixteen men. 
\i : lie starboard battery on the I rt of the lower deck ; 

Seven men. 
A i I lie magazine on ill • fore pari "l the lower deck ; 

Eleven seamen acting as i nunition suppliers. 

A i tbe (i ire piri ' .1 (lie l< »wer deck ; 



THE BATTLE OJF YALU. g 

Three band-men and one paymaster's assistant on 
ambulance duty ; two seamen ; three carpenters 
stationed there for fire-brigade work. 
At the upper part of the fore- engine room ; 

One stoker. 
At the torpedo-room of the fore part; 

Three torpedo men. 
Ar the torpedo-room on the starboard side amidships ; 

Sub- Lieutenant A. [de (twice wounded), and two tor- 
pedo men. 
In the neighbour hood of the torpedo-room amidships; 

I >ne carpenter acting as tire-brigade man. 
At midships on the lower deck; 

1 wo seamen. 
In front of the gun-room on lower deck ; 

Sub-Lieutenan1 < '. Sasaoka acting as the lower deck mate. 
At the tore part of the upper deck ; 

Warrant officer M. Okuborn : three band men on 
ambulance duty, one black smith stationed as fire- 
brigade man. 
At the hospital on the tore part of the upper deck ; 

Deputy Inspector General H. Kawamura; one petty 
officer, and one paymaster's assistant, acting as 
hospital mates. 
In the warrant officers' room on the fore part of the upper 
deck ; 

One clerk in the staff service. 
In front of conning tower; 

A signal man. 
At the starboard battery on the tore part of the upper deck ; 



10 THE BATTLE OF V.V1.0. 

( >ne seaman. 
At the entrance of the first hatch on the fore pari of the upper 
deck ; 

Two seamen acting as ammunition carriers and a 
signal man. 
On the steps of the first hatch ; 

A cook. 
9. — The top of masl was damaged slightly by a shell. 
Hi. — The coffer-dam "ii the starboard side was perforated by a 
shell. 

1 1. The lower pari of the main masl was perforate I by a shell. 

12. -The launch and gig were damaged by n shell. 

■ onr squadron, ti, liima was I 

; number of deaths and injuries on board lier amounting mrth 

and one-third of the total fore f the squadron. The subjoined 

report will show how hard the medical staff of th M ' isliima were pul to it. t i per- 
i irm their duty under these tryiu 

a board the Matsushima during the i :it in 

the 5 l by £ in M. Kusauo : — 

\i t "il p.m., aber L6th, L894, mx warship I principal squa 

four of the first flying s |iiadron, the gu i-boal Mcagi and a transport Saiky5-mar i 
Taidou bay, Korea, for the island of Baiyang, C uiing a line ahead. Earl} 

on the 17th, they arrived at their destinatiou and ord Ucagi to reconnoiti 

i ! : time, tb i jualled " Nn enemy's ship 

visible," and the fli t pro led towa ! loshati Uliulfpasl 10 a.m., they ob- 
- I, in the arisiug abo\ e the 

ted the ] isition of the enemy, as thej approached, the vo 
iusly, and now being certaiu that this smoke p 

mont and enthusiasm of the sailors were boundless, 

ii. -r thau usual and as s as they liul finished, 

immand 

I prep in I m .f the 



THE BATTLE OF YAT.f. 1 [ 

lower deck and waited to receive the wounded with Assistant Paymaster Takei 
and medical attendants as help-mates. 

About fifty minutes past noon, the battle commenced, the bombardment on both 
sides growing gradually more and more violent, and a furious rain of shells from the 
enemy fell on all sides. On the upper deck, a 15 cm. shell exploded against the 
turret of our 32 cm. gun, and one of the gunners was injured by the flying pieces at 
55 minutes past noon ; at 1.20 p.m. a shell bursting against No. seventh light Hotch- 
kiss' gun destroyed the gun, and two persons were killed, and two injured by pieces of 
the shell. About 2.34 p.m., I went nut to give instructions for carrying the wounded ; 
I crossed the deck to the starboard gun room just opposite the temporary hospital and 
at this instant, a rumbling noise, and a violent shock suddenly arose, and I knew that 
some shells had struck our vessel ; going back immediately to the hospital I discovered 
that exactly where I had been standing a moment before had been obliquely perfo- 
rated by a 2ii cm. shell discharged from the Chinese ship Ping Yuen. The greater 
part of surgical articles were destroyed by this shell and the rest were scattered here and 
there. As work in the hospital under such circumstances, was impossible, I tried to 
prepare a hospital in a gun-room on the starboard side or in the staff officers' cabin, on 
the after part ; but the majority of medicines and surgical instruments having been 
either damaged or lost, [ thought it better to trausl :r nr. self to the hospital on theupper 
deck, and informed the officers of the battery on the lower deck of my purpose ; accor- 
dingly Assistant Paymaster Takei, and others and myself reported the state of damage 
to Dr. Kawamura, Surgeon-General of the Squadron, and Dr. Ogisawa, Chief Surgeon 
of the slup. About 3.30 p.m., as I was ocsupied in assisting Chief Surgeon Ogisawa to 
treat a case of mutilation of limb, and Surgeon-General Kawamura was treating a 
case of mutilated wound of the abdominal wall with Assistant Surgeon Abe, two 30.5 
cm. shells struck the ship, at the same time, one of them exploded with tremendous 
force again-t tli i shield of 12 cm. gun of Xo. 4 on the port side of the fore part of the 
lower deck, where the tempoian hospital was stationed ; the deck was torn up and 
the gas produced by the explosion filled all around, so that nothing could be seen, and 
one could only hear an indescribable cry, and tremendous sound. Two severely wound- 
ed persons who were just under treatment in the hospital died from the shock, I was 
momentarily stunned and had a peculiar feeling as if the ship was sinking. Thinking 
that all the officers would be standing on the after deck according to their ranks, wait- 
ing an honorable death, I determined to die with them ; but was nearly suffocated while 
endeavouring to reach the deck, besides stumbling over articles scattered all about, but 



12 ["HE BATTLE 01 5 wi- 

lled with thick gas and blinding all around, I \ 
■ ii toward tbe after part of the starboard side ami narrow]. 
[own to tli.- lower deck, as there was a gap produced by the perforation 
■ irboard si. If. which one was nnal i the 

I the back part of the officers' kitchen, the clouding smoke cleared 
that our ship was navigating as usual, bnt a great 
with burns came to the officers' room and captain's cabin, some walking 

- ■ burns v. re, the cries and groans 

i ral Kawainura was lai<l on a bench in the offici 
with a spinal concussion and contusion ol the ankle joints hut Fortunately Chief-Sui 
stant-Surgi on \1 1 . and the medical ntt< ndants ■ As tin i 

I instruments w< re scatti and there in disorder by tin 

struction » pital. and finding that the greater nun:' wounded were 

I urns, I determined to substitute: oil for the engines for dressing the 
burns, and aft* I Dg the chief-engineer, "Shirashinu nil " was brought and 

It was no eas\ matter even to perform a temporary dr< 
such nun finished it with the assistance of Paymaster Fnjita, who 

was occupying : Standi Squadron. Nol only the 

d, the captain's cabin, and wardroom, but ai- 

tnajority having hums on their 
and the cri< s and moans wen Ii scription 1 1 e total numh 

d was thirty five, from a large shell of the Chinese man-of-war Clan Yneu, which 
ir gun shii Id. As a n -'i!t the ammunition for side guns heaped up 
on t: I itenant Shima. Sub-Lieutenant It5, Midshipman 

Oishi both sides, magazine men, and 

earn andred in number were either kill. 

I from it. 

•hell from the Ping Ym 

an iron 
ii and nil tank, after striking tbe hospital on 
in-mounting of :\'l cm i the 

\> onr 



THE BATTLE OF YALtJ 13 

IStli, a temporary hospital was established in the captain's cabin, and the medicines 
and instruments, which were scattered about and undamaged were collected, but as 
there was not enough, cotton was used for lint ; lime stored for ship's use and shira- 
shime "ii for engines were used to make a liniment, brandy for the officers' table was 
given to patients ; clothes of officers arid men were also given to patients Not only 
such important medicines, as anodynes and stimulants, were wanting, but the 
dispensing apparatus were nearly destroyed, so that under these circumstances, 
patients were moaning with agony everywhere, and being so numerous, were 
obliged to wait a very long time before their turn for the dressiug of their 
wounds arrived, although we did our utmost to console them. We ourselves had no 
leisure time to take regular meals, and contented ourselves by sipping condensed 
milk. Even working so hard, it took us from 7 a.m. till 10 p.m., to get through 
with dressing their wounds. Ten ol I | us severely burned died on the 18th, 
five on tiie 19th, and three on the 20th, making eighteen in all. lint owing to the 
numerous patii nts with burns remaining, we could net sleep even for a short time at 
night, and this deficiency of sleep, and poor supply of food so fatigued us that we were 
only able to perform our services by taking stimulants. We got a very great help 
from the bandmen, who assisted the medical attendants, and lightened more or less 
their work by watching the patient-. 

On the 19th, the dressings and medicines were diminishing, and we found they 
would not hold out much longer : although we expected to reach Port Sasebo on the 
next day, yet it was uncertain as the change of weather and severe damage of the 
-hip might cause delay, — we economized the consumption of medicines as mucb a- 
possible. As we anticipated, about midnight some derangement occurred to the 
engine and only the half side of the engine could In- used. The speed decreased to 
half and an adver.se wind with high sea made it still worse. Every time the wind 
raged, sea water overflowed on both sides through the damaged holes, rhe patients 
who wen complaining at not arriving at their destination as soon as they expected, 
were discouraged by perceiving the death of their comrades: it was difficult for 
us to conceal it from them and we could net help shedding tears. On the "20th, when 
we ob the top of the mountain ranges in Hizen Province, the wind and waves 

got calmer and the speed increased again. All persons on board the ship now felt more 

and the patients were encouraged by hearing Port Sasebo was near at hand. 
Approaching the port, a short time after, signals were made for signal stations in Hejiki 
(Hirato island) and Cape Kogosaki, by which preparations and arrangements for 
litters, porters, and boats tor patients, were requested of the Sasebo naval hospital. 



14 THE B.\ ITLK OP I ILO. 

As soon as anchor was oast in Sasebo " >rt, surgeons of the hospital came on board 
the shin immediately with litu-rs. and boats with medical attendants. Those 
who were injured slightly and could walk were sent to the hospital first, and I 
beared severely were carried auder complete protection to tho hospital by litters. 
Phne we finished onr responsibility at 1 a.m. of the 21st. 

The ItSUkushima. I- At 1 p.m., :■ 21 cm. shell struck a 
boom of torpedo netting, on the fore pari of the starboard side,al the poinl 
of •'! metres above sea level and exploded, making a dole about 1.3 m. 
on the side and entering the torpedo room, damaged :> part of the racer 
and weston tackle ; and here the pieces <>t shell were scattered in .-ill 
directions; the two large pieces making a hole of about 30 > m.m.on the 
port side, and the other pieces killing eight men and wounding three. 

2. A.I 1.05 p.m., a 1"> cm. shell [perforated the <-".-il bunk- 
era in midship ol the starboard side, at the point of 600 m. tn. 
above sea level; it passed between tin- hatch way of the fore engine 
room, .-itid the aft boiler room, making a bole "I •">.•"> m. by ,( .I7 m. in 
the iron septum between two rooms, and destroyed m ladder between 
the middle step ol the aft boiler room and the mid-deck, and here the 
shell exploded ; the pieces of it dispersing in .-ill directions, made two 
small holes in ;i fresh water tube used for the ten ton pump in the 
lore boiler room ; two holes in the iron 'lour closing the boiler room, 
and a small hole in the steam pijxj of the ventilator for the aft boiler ; 
they also destroyed ;i frame "I' the ventilator, and crushed the spindles 
for the sluice valve in the bottom, between the fore and afi engine 
les the gratings ol the upper and middle step ol the afl 
boiler room, and the middle step "l the fore engine, an I boiler room 
urn- slight!) damaged. \ stoker in the afl boiler room wsis killed 
and Assistant Engineer Matsuznwu injured. 

A: 1.20 p. m., a 15 c m. shell perforated the main mast from 
the - ■'< hi ■' res ibove the upper 'leek, in I 



THE BATTLE OF YALl). 15 

cut off the voice tube, the cable of the distant director, and the chain 
of the ammunition lift, and perforated the funnel of the port steam 
launch, finally falling into the sea without injuring any one. 

4. — -A 50 in. in. shell perforated the admiral's bed room in the 
stern, from the starboard side, at a point U metres above sea level, 
and exploded against si marble table. The pieces of shell scattering 
destroyed the door of the room and three chairs on the port side, after 
piercing the wall of the room. No one was cither killed or injured by 
this shell. Time not precisely known. 

5. — At another time, a ten centimetre shell perforated obliquely 
the starboard pinnace and first gig, and entered the wardroom galley 
on the midship of the upper deck, and burst (not exploded) here, per- 
forating the iron septum, and passed through to the gun-room galley, 
here also perforating the iron septum. Then it entered the baking 
room severing the entrance door from within, and finished its course by 
the door ofthemeu's water closel on the port side. No injury. 

6. — At .'! p.m., a 50 ni.m. shell struck the midship of the star- 
board side at a point about three metres above sea level, and 
perforated the aft coal shoot, lodging eventually in a starboard 
coal bunker. 

7. — At 3.20 p.m., a 50 m. m. shell discharged from the Ping 
Yuen exploded through the upper part of a port scuttle on the fore 
part of the middle deck, and ignited the clothes' shelves on the port 
side of the mess-deck ; but it was immediately put out, and no injury 
occurred. 

8. — At 3.30 p.m., a .~>u m.m. shell exploded through the port 
netting on the fore part of the upper deck at a point 6.5 metres 
above sea level, and took tire. L'he pieces of shell, striking the turret 
of a 32 i:.m. gun, dispersed, and killed two stokers on the grating of the 
highest part of' the fore boiler room, and two men on the fore part of 



If, THE BA I I'LE 01 > \l.f 

the upper deck, and injured li\ e men. 

Besides the above mentioned casualties, four men mthestarl rd 

Hotchkiss' batter) on the highest deck and one man on the upper 
deck had their membrana tympani ruptured bv vii)lenl shocks from 
bi« guns discharged on the lower deck. 

The Hashidate. I. — A.1 1. 10 p.m., ;i L5 cm. shell entered 
the turret destroying the upper part of the right side of w 32 c. in. 
gun on the fore part of the upper deck, at ;i point (i.7 metres 
above sea level, and exploded against the centre of the inner surfai 
the turret-vault. The fragments damaged ili>' inner surface <>f the 
turret, hut the thickness of the turret being 300 m.m. the damage 
was very slight ; and the gun, hydraulic machine, and gun mounting 
were uninjured. Lieutenant V. Takahashi, who was directing the 
gunners, Lieutenant k. Senokuchi, and ;i gunner, were killed in the 
turret : and tour men in the turret, and live on I lie port side ol 
the fore part of the upper deck were wounded. 

'1. — A i 2 p.m., a 1 ."> cm. shell perforated the star'noard midship 
of the lower deck, :tt .-i point 2.3 metres above sea level, and 
exploded against the iron plate, between a store room and :i coal In inker. 
A pari of the shattered shell lodged in a coffer-dam in the coal 
bunker, the other pieces lodging on :i clothes' shelf, after having des- 
troyed a part ofa chest of drawers in an engineer's r NTo one 

\\a« killed or injured. 

'.'>. -Ai i time not ascertained. ;i 15 cm. shell perforated 
ihe outer plating below the port ol No. l) starboard nun on the 
Biern, al ;i poini one metre above sea level, and lodged, without 
bursting, in the coffer-dam. 

I. \t :i lime not ascertained, :i 17 m.m. -~ 1 1« -I I exploded against 
Ihe oulcr plating of the starboard waist, at :i point 1.03 metres 
above sea level, f Is pieces destroyed the brii No. 5 coalin" hole, 



I UK BATTLE OF YALV". 17 

starboard bidder, the booms for the torpedo-net, and the lorpedo-net itself. 

5. — A.t a time not ascertained, a 47 m.m. steel shell passed 
through the right side of a (ire casing, at a point 7..") metres 
above the sea level, and simply fell down upon the boiler without 
exploding. No casualty. 

(5. — At a lime not ascertained, a 47 m.m. steel shell perforated 
(he iron cover of the funnel hanging on the right side of the (ire 
casing, but. a- it lodged without exploding, it caused no injury. 

7. — -At a time not ascertained, a 37 m.m. steel shell stopped in 
a hammock, perforating beneath the starboard hammock netting on 
the upper deck under the bridge, :it a point li.7 metres above sea 
level. 

<S. — At a time not ascertained, a 57 m.m. steel shell cut off" the 
chains of the midships stockade of the starboard side at a point 6.1 
metres above the sea level. It also destroyed a pinnace anddinsrv, and 
stopped at the lower portion of the door, leading to the officer's galley 
without explosion. No case of killed or injured. 

!). — At a time not ascertained, a 57 m.m. shell penetrated the 
starboard midship, al a point 7.58 metres above the sea level, and 
passing through a whaler and a barge, fell into the sea without 
explosion. 

lit. -Al a time not ascertained, a .'17 m.m. steel shell, at a point 
of 6.7 metres above sea level, exploded against the lower portion of 
an awning stanchion outside the starboard hammock netting on the 
upper deck below the bridge ; the pieces of the shell fell into the 
water without causing any casualty. 

11. — At a time not ascertained, a 47 m.m. steel shell came from 
the starboard side and fell into the water on the port side perforating 
the middle of the flay hoisted on the rnainffaff. 

Besides the above mentioned, a mm who was serving with the 



18 : UK BATTLE "1 V \l.t 

Botchkiss' gun had his membrana tympani ruptured bj the shock oi 
a gun fired on the poop deck. 

The Fuso. '■ A.1 3.50p.m., a 30.5 cm. steel shell (?) struck 
against the stern on the port side, at a point 1 metre above the sen 
level, leaving a round hole of 320 in.m.; destroyed the command- 
er's cabin, perforated the lower part of the wall in the cabin, :md 
crushed the fresh water pipe leading to the captain's gallej . also severing 
the wall between n torpedo officer's and ;i lieutenant's cabins. It 
then passed across toward the starboard side and entered the ward- 
room, crushing the tables and chairs, and damaging an iron pillar. 
two arm racks, and three walls in the room, again, flying up oblique- 
ly, it destroyed the wall between the chief uavigatiug and gunnery 
lieutenants 1 rooms in the middle deck of the port side. Lastly it 
flew oil', perforating the starboard side near the navigator's room and 
leaving a hole of 1.28x0.65 m. No casualty. 

2. At a time not ascertained, a 30.5 cm. shell exploded, falling 
into the sea near the starboard side of the bow and its fragments 
rebounding perforated the lower pari of No. - scutrle on the starboard 
bow, at a point 1.32 in. above the sea level, ilm~ making a round hole. 
which measured 180 m.m. in diameter, on the starboard side near the 
upper portion of the middle deck (mess-deck) j finally, it stopped at 
the water way. No case of killed or injured occurred. 

3. At l.i'l p.m.. a 7..") cm. steel shell perforated the water 
w:i\ on the upper deck midships, starboard, at a point 4.55 in. above 
the sen level, and made a round hole .*| 65 iii.ni. on the outer plating, 
and .-in oblong hole of 80 in. m. on the inner plating. It then ex plod- 
ed against the booms and an iron pillar on the port side. Fragments ol 
the. shell and other splinters wounded two men on the 3rd 7.5 cm. 
gun battery and Sub-Lieutenant I chizaki on the port batter} of the 
upper deck. Another fragment struck the semaphore signal staff on 



THK BATTLE OF YALU. ]q 

the fore bridge and fell on to the bridge itself, injuring Sub-Lieutenant 
Maruhashi who was standing there. 

4. — At 2.31 p.m., a 30.5 ctn. steel shell (?) came from the 
starboard side, bending a portion of the rail for raising ashes on the 
upper deck, and, after perforating the lower part of the funnel, and 
the bulwark in front of the 17 cm. gun on the port side with holes 
of 0- -10 in. and 1.2x0.57 in. in diameter respectively, flew off on the 
port side. At this time, two men were killed by the fragments of 
funnel, and eight men were wounded. Most of them were lying on 
the left side of the runnel, when the order was given to stop firing 1 
the guns. 

5. — At a time nor ascertained, a 17 cm. shell perforated, from 
right to left, the middle part of a ventilator behind the funnel on 
the upper deck, and made a round hole. It also destroyed the fore 
portion of the keel of a gig, the left arms of the booms, and a por- 
tion of the netting on the side of the 2nd 7.5 cm. gun, and 
exploded on the port side. No casualty. 

(i. — At a time not ascertained, a shell burst against the middle 
portion of the after davit of a galley on the starboard midship, that 
is, 300 m.iii. above the netting, and burned a hammock. 

7. — At a time not ascertained, a 15 cm. steel shell perforated the 
port netting on the side of the foremost davit of 2nd cutter on the port 
stern, outwards and down wards, making a hole of 1.<S in. It then 
flew off Oil the porl side. 

<S. — At a time not ascertained, a shell of a 6 "kin quick firing gun 
(?) perforated the netting, beneath the after davit of the starboard 1st 
cutter on the stern, from above downwards and inwards, making a 
hole of 80 m. m. in rlie inner plate of the netting, and cutting oft* 
a haul of the 1st cutter. It then exploded towards the opposite side, 
but without casualty. 



•JO THE BA II I. K OK V W.&. 

Besides the above mentioned, the knee below the electric light 
of the fore mast, the upper deck, tin' funnel, the ship's sides, boats, and 
llir risrsfinjr ol tin- main mast, showed marks "I -mall shell pieces and 

o i 

small shots, bill vvhal directions they came from was uncertain. 
The injuries caused by them were verv slight, so thai these are not 
worth inenl ioning. 

The Chiyoda. '■ cV( '-5.23 p.m., n :.'! cm. shell penetrated 
the porl midship, al ;i point 1.95 metres above the sea level, making a 
hole of 0.27 in. in diameter and passing through the paymaster - store 
and ii portion ot the lower deck. Ii theu entered the engine room 
above the armour door and Hew oul through the starboard side near 
the water line, destroying in its course a portion of the starboard side 
■ •I the lower deck and the starboard coal bunker. No casualty. 

-. Ai a time nol ascertained, :i shell from ;i Nordenfell machine 
gun penetrated the starboard how ;ii n point ,").,") m. above the sea 
level, and tell upon the tipper deck. There it stopped without 
inflicting an) injury. 

.".. \i :i time uol ascertained, a shell from a Nordenfell machine 
gun passed through the starboard torpedo-director on tin upper deck 
ol i he stern, and did :i lilt le damage. 

In addition to the above, there were two marks lefl by Nordenfell 
machine gun shells. One ol them was on the port midship al a point 
."p. .")."> metres above tin sea level. L'he other was n little nearer to the 
how al a point aboul 2.35 metres above the sea level, lioth ol them 
failed to [ierfi irate the iron plating. 

The Hiyei. •• -Ataboul 1.15 p.m. a -I cm. shell came llv- 
iii. over the netting ol the starboard waist, and, piercing the pinnace, and 
the keel ol the steam launch above the booms, aboul ."> meters above 

the sea-level, exploded against the stanchion of the [K>rl I tns, 

teariii" one third ol ii> upper part. The fragments •>! shell ll\ i 1 1 •_; in all 



THE BATTLE OF V \U" 



•J I 



directions caused heavy damage to the port waist deck and several 
places on -the side; and at the- same time produced an explosion of 
guu powder in the bags belonging to No. 4 jjnn. At this time, 
three men belonging to No. I port battery on the waist deck, were 
killed by the fragments, and one man by the explosion "I the powder; 
Lieutenant M. rakashima, commanding the port battery, and two 
men .wen- also injured bv the fragments or wooden splinters. 

2. -About 1.17 p.m., a 12 cm. shell dashed into the upper deck, 
(about -.'■> meters above the sea-level) through an open port at 
the lower cud ol the starboard cutter davit at the stern, damaging the 
planks around the sea port. Il then leli the ship by a stern port 
hole without exploding; but during its passage il knocked ntf the 
bead ol a man of No. !• gun. 

'■'<. -At about 1.18 p.m., a 1 .*i cm. shell smashed the aft and 
upper part oi the stern starboard port, then turned obliquely astern 
and left the ship, making a hole through the port side of the stern 
where the life buoys were. At the time, four men in the battery of 
No. !l gun (stern gun) were wounded by broken wooden splinters. 

4. About 1.20 p.m. a L2 cm. shell pierced through the ship's 
side behind No. 7 guu port in the middle of the starboard, crushing 

the w len and iron planks as well a- the irou-ving of the elevator 

of No. 7 gun : and the shell, not bursting, glanced off over the port 
netting, wounding three men with the wooden splinters and. one with 
a broken piece of iron. 

5. — -About L.25 p.m., a 17 cm. shell exploding on the sea near 
the starboard, some of il> fragments rebounded cutting off the mast- 
head-iine and striking against the main mast-head, some fragments of 
the shell and the iron wall of the mast fell through the hollow of the 
mast into the engine room. No one was injured. 

(i. — About 1.25 p.m., a 47 m.m. shell entered the lower deck l>v 



22 THE BATTLE Ol V U-tf 

making an aperture through the starboard side in fronl of the bridge, 
:it :i point 0.7 meter above the sea-level, and shattered the shelves 
in the captain's sculler} ; the shell bursting, the fragments and wooden 
splinters were scattered in all directions, greatly damaging the utensils 
and the walls ol the room. One of the fragments flew oul of the 
room and entered :i clothes-box, where it lodged. No one was killed 
or injured. 

7. — Aboul 1.27 p.m., a 15 am. shell passed through the netting 
above No. 5 gun porl behind the starboard gangway, and Hew off 
over the porl netting without doing any one an injury. 

•V -At ii lime not ascertained, a ;>7 m.m. shell came from the 
starboard side and passed into an oil-tank (about .">..> meters above 
the sea-level) on the upper deck of the stern behind the bridge, and 
lodged there wiihoul causing injury. 

!'. — About 1.30 p. in., a 30.5 cm. shell passed through the ship's 
side, striking the lower-deck below the cutter davil at the starboard 
stern (aboul 1 meter above the sea-level). It came through the 
captain's bed-room and broke into the wardroom, where it struck the 
iron nii/./.eu-mast. and, exploding, smashed it, at 900 m.m. above the 
lower deck. The fragments Hew in every direction completely 
destroying the wardroom, the captain's cabin, bis l)ed-room and 
water closet, the chronometer room, and the rooms ol the I -i and 2nd 
lieutenants, also the room* ol the chief surgeon, the chief paymaster, 
the gunnery lieutenant, the torpedo lieutenant and the chiel engineer. 

ie~ this the account room, gun room, and gun-room scullery, 
and the desks, chairs, and various other furniture in all those apart 
men Is w royed. The lower deck bad a hole of 3 square meters 

and the upper one ol '2.5 square meters; the 3rd and Ith water tight 
door* V i pump in the tth section of the lower deck, the iron 
ns, II scuttles, the provision store, the magazine beneath the ward 



THE BATTLE OF \ ALU. •_>;; 

room and the port ladder of the bridge, the ventilator, and the ship's 
side were all destroyed or injured. The shock of the explosion 
produced cracks in the commander's cabin, the chart room, the chief 
navigator's room and on the bridge; and the gas of the exploded pow- 
der and the wooden splinters passing through the two sky -lights on 
the top of the wardroom caused injuries to those who were on the 
quarter-deck. By this accident 14 were killed on the spot and 2G wen- 
wounded either by the fragments of the shell or the splinters of the 
timber and furniture. They are as follows: (Refer to the diagram 
of the destroyed lower deck of the ship in the fourth chapter.) 
In the wardroom (the surgery) of the 5th section of the lower 
deck ; 
Killed: — 

Chief Surgeon, T. Miyake. 
Chief Paymaster C. Ishizuka. 
Assistant Surgeon, C. Murakoshi. 

One medical attendant, three bearers, and two wounded 
men. 
Wounded: — 

Two medical attendants, one bearer, and one wounded 
man. 
Near the entrance to the machine gun magazine (beneath the ward- 
room) below the lower-deck : 
Killed : — Two men. 
Wounded : — Four men. 
In the stern cabin ; 

Wounded : — Four men in charge of the relieving tackle. 
In front of the accountant's office, on the port side in the 4th section 
of lower deck ; 
Killed : — Three men of the fire-brigade, 



2 4 



1 mi. BATTLE OF \ VLO 



In the lih section of the lower deck ; 

W i iiinded : 

Sub-Lieutenant M. Ogawa, lower leek mute and lour men. 
In the 3rd section ol the lower deck ; 

\\ i >t 1 1 ii If. I : - L'hree men. 
( )u i lii quarter deck : 

Wounded : Five men. 
( hi the bridge ; 

Wouin lei 1 : < 'in' sigual man. 

LO. Iboul 1.30 p.m., a 17 in. in. shell struck the 2ud cutter on 
th< porl side near the stern from the lefl side to the right (6.5 meters 
above the sea-level), and then passed off, destroying both sides of the 
1st cutter mi the starboard side. N" injury to officers or men. 

11. Aln.nl 1.30 p. in.. ;i 1 - e.in. >'ut II pierced the lower pari ol 
the netting in Iron I "I the porl gangway, uud then, passing jusi below 
the booms, duuiiiged the ship's side behind \n. .'i gun porl on the 
starboard side, and proceeded on its way. No injuries. 

\'l. Aboul 1.30 p.m., a shell exploded on the water near the 
porl side. The rebounding fragments struck the ship's side, where the 
porl shed anchor lay, and lodged there | 1.2 meters above the sea 
i I). 

13. Aboul 1.30 p.m., fragments of a shell exploding on the 

surface of the sea rebounded, and slighl Iv damaged i In ter plating 

of the ship's side jusi below the lower pari of the starboard cutter .-it 
the iti in . I meter aliove the sea-le> i 

1 I. Vbonl 1 .50 p.m., :i 17 in. in. shell struck the ship's stern (I 
in. above the sea-level) where the starboard life buoy lav. and then 

passing over the iipjier deck to the left, destroyed the \\ leu planks 

in fronl mi the upper part of the chief navigator's room, and leli the 
-hip [mi< iliquely toward I he left. The junior navigating officer 



THE BATTLE OK YALt. •_>;, 

Sub-Lieutenant Y. Tanaka who was at the port .side of the chart-room 
on the upper deck, was wounded by the flying wooden splinters. 

15. — At some time not ascertained; fragments of a shell exploded 
on the sea. near (he port side, rebounded, and slightly damaged the 
outer plating (3.3 meters above the sea-level) at the port side of the 
stern. 

16. — At an uncertain time; fragments from a shell that had 
exploded mi the water, shattered the outer plating at I he lower pari of 
the starboard cutter. (1.2 meters above the sea-level). 

17. — At an uncertain time; fragments of a shell that bursl on 
the sea near the port side damaged the outer plating of the side (2.4 
meters above the sea-level) behind the place where the port stream- 
anchor was lying. 

18.— At an uncertain time: a \2 cm. shell pierced from 
right to left through both sides of I he stern of a steam cutter placed 
above the middle booms (5.9 meters above the sea-level). 

1!). — At an uncertain lime ; a 17 m.m. shell came sweeping over 
the midship starboard netting and broke through the gunwale of the 
port gig (5.5 meters above the sea-level). 

20. — At an uncertain time ; a shell destroyed the main top-mast 
cap. and damaged the starboard main royal lift and shot through the 
ship's flag on the main mast. 

21. — At an uncertain time ; fragments of a shell that exploded on 
the sea near the port side lodged in the heel of the mizzen-mast. 

22. — At an uncertain time ; a shell grated the machine gun 
battery (5.2 meters above the sea-level) on the poop deck, without 
injuring any one. 

2l>. At an uncertain time : fragments oi ;i shell that exploded 
on the sen near the port side damaged outer plating of the side (4.5 
meters above the sea-level) below the fish-davit of (lie forecastle. 



THE BATTLE OF YW.fr 

Further, during the preparation tor action previous to the engage- 
ment, n man in charge of a torpedo-tube was injured while conveying 
a torpedo; aJso, several ropes wen- cul either by shells or splinters; lmt 
no record i> made of these cases, as they were not accompanied by any 
personal injuries. 

At the battle of the Yellow sea, it was the Hiyei that bore the brant of the 
fight. Oil one occasion, she was wholly surrounded by tho enemy's ships and ber 
fab seemed almost sealed ; consequently the damages and losses sue sustained were 
lingly great For the numbers of killed and wounded, she stands m-xt to the 
Sdatsushima. To complete the tale of her disasters, the surgery was utterly 
royed by a shot and the whole of her medical staff either killed or severely 
wounded. The wounded were thus compelled to rely upon non-medical men for 
temporary relief; and it was not until the ship returned to the fleet station, near the 
Chopp Cape, that she was at last able to have the suff rers treat 1 '•'. 

on- from other ships. The report below, furnished l>y Chief Surgeon B 
Fomatsuri, who was principally engaged in the management of the wounded, and 
other medical affairs alter thi disabling of the Biyci's medical staff, will throw somo 
light on the details of the hard fight and the behaviour of the medical men during 
that time. 

Report from personal observations on the mans i the killed and woui 

in the battle of the Yellow sea, by B T atsnri, Cb >n of the Hiyei, i 

ing the late Surgeon '1'. Miyake. 

The naval fight between the Japanese and Chi Yellow sea on 

I Ttl. S( pti mber, l*'.l I, lasted as long a- five hours, the fight being carried on with 

the utmost energy and courage on both sides, and with ships and machinery of the 

I style. <'ur fleets therefore could not escape a large loss in killed and woub 
Personal observations of the management of the suffi rers on , ieh . e el i ugagi 1, can 
not I believe, hut be of great benefit to those who serve in the medical aud san 
departments of tin' navy. The Hiyei was in th tho fight, hut un 

fortunately her tw the battle aud the ciroumstanc 

the time can from anj surg i m iring 

the battle At the time of I I ■■ il tin vous ><i\ hoard 

the transport Doyo-maru The following i ning, [came on board tho Hiyei when 



THE BATTLE OF YALfr. -27 

[ had the sad duty of inspecting the corpses) of those who had honorably died, and 
of treating the wounded. Then, being appointed chief surgeon of the ship in 
.succession to the late Chief Surgeon Miyake, I had the honour of re-arranging her 
medical affairs. Here I humbly report on the circumstances of the battle as far as 
I was told them by actual witnesses on board the ship and on what I observed 
there myself afterwards. 

At 5.11 p.m., on the 10th September, tin ■ Matsushima, Chiyoda, [tsukushima, 
Hashidate, Hiyci, Fuso (the Main Squadron), the Yoshino, Naniwa, Akitsushima, 
Takachiho (the First Flying Squadron), with the Akagi and Saikyo-maru, num- 
bering 12 warships in all, departed from the temporary anchorage near Cape 
Choppeki in Korea, and during the following morning, (the 17th) cruised about the 
vicinity of Haiyang island off the Shing-king district of China, in search of the 
hostile fleets but in vain. We now changed our course to the notth-east, and ap- 
proached the mouth of the river Taiyang when, at about 11.30 a.m., we descried a 
few steam-ships at a distance. Coming near them, we recognized them as a Chinese 
fleet consisting of over ten ships. At 0.8 p.m., a big flag was hoisted on the main 
mast of the flagship Matsushima ; following her example, our ship hoisted a flag on 
the main mast and blow to quarters. At the signal, Chief Surgeon, T. Miyake, Chief 
Paymaster C. Ishi/.uka, Assistant Surgeon C. Mnrakoshi, and three medical attendants, 
numbering in all, assembled in the wardroom in the 5th section of the lower deck 
assigned as the surgery, taking with them every article necessary for treatment, and 
covering the table with a rubber sheet, so that all preparations were made for 
receiving the wounded. At 0.50 p.m., firing was opened by the enemy's fleets to 
which ours did not reply until we got at a distance of 4,000 meters from the enemy ; 
at 1.08 p.m., both fleets approached by degrees, the Chinese fleet changing their 
position gradually, the angle of the enemy's double quarter lines seemingly intending 
to intersect our line ahead. At about 1.14, our ship being unable to follow the 
Hashidate, which advanced just ahead at a suitable distance, we fell behind to a 
distance of 1,300 meters, when two hostile vessels at the angle of the lines, deeming 
it the sole opportunity for attack, turned their helms, and bearing down upon us 
were about to ram us. The peril was imminent, but, with desperate resolution, we 
determined to thrust ourselves through the enemy's line, by making free use of the 
helm, so as to throw the enemy's lines into confusion. Showers of shots and shells 
were poured upon us from the foe on both sides. The gunners on either side of our 
ship worked desperately at their guns ; four men at No. 4. gun, and one at No. !• 



28 



THE BATTLE OF YALU. 



gun being killed outright, and Lieutenant Takasliima, who was directing the battery, 
with ten men and one stretcher-bearer, being wounded. This manoeuvre was quite 
successful; our ship passed through the enemy's line and was about to effect her 
escape, when she was pursued by the hostile ships. Ting Yuen, Chen Yuen, and Sai 
Yuen (?). A 30.5 cm. shell fell into the wardroom (the surgery) through the 
captain's bed room on the starboard, where it hit the mizzen-mast and exploded, 
causing terrible damage iu the ship, so that forty officers and men were killed or 
injured at onetime (the places damaged and the names of those killed or wounded 
will mil. lie stated here to avoid repetition as they are detailed in the text). 

The articles iu charge of the chief surgeon, destroyed by the explosion of the 
80.5 cm. shell in tin- surgery, are as follows : — 



DRUGS. 



Carbolic acid 9,000 gm. 

Dilute hydrochloric acid 1,500 

Plaster of Paris 4,000 

Sulphate of quinine 19(5 

Muriate cl' cocaine 1 

Corrosive sublimate 60 

Chloroform 250 

Iodoform 550 

Strong solution of per-chloride 

of iron 225 ,, 



Hydrochlorate of morphin i ... 1 gm. 

Salicylate of sodium 2*27 ,. 

Sulphate of magnesium 1,000 

( lastor oil 550 .. 

Dover's powder GO .. 

Brandy 050 .. 

Vaseline 500 .. 

Ltefiued camphor (i ,. 

Ether 54 .. 

Tartaric acid 70S .. 



CONSUMABLE MATERIALS. 



Sponge 4 

Paddings i". n- wooden splints... I sheets, 

< lottOU cloth 01) " Inn." 

Lint 2 " ton." 

Cotton wool 450 "milium. ." 

Linseed oil paper 25 sheets. 

Triangular bandages L00 

Silk threads ......"/ " momme ' 7 " Inn. 



Pins 182 pieces. 

Leathers 3 

Oiled paper 20 sheets. 

Bladders 9 pieci s. 

Earthern cups 3 

Earthem bed pan 1 

I. : lllhes 11 

Soap 6 pieci s. 



THE BATTLE OE YALU 



29 



Nail brushes 2 

Wax matches 1 box. 

Corrosive sublimate gauze ... 25 " 'tan." 
Corrosive sublimate cotton- 
wool 800 " momme." 



Rubber tabes 5 "shaku." 

Splints (large) 30 pieces. 

Splints (small) 50 pieces. 



PERMANENT INSTRUMENTS. 



Third elass surgical instrument 

case 1 set. 

Razor 1 

Brass irrigator 1 

Dressing trays 3 

Brass basins 3 

Brass spitoons 3 



Stretchers 2 sets. 

Medical sack 1 set. 

Portable surgical bag 1 set. 

Dressing instruments 1 set. 

Iron spatula 1 

Brass pitcher 1 

1 ipper pan 1 



NON-PEHMANENT INSTRUMENTS. 



Hypodermic syringe 

Clinical thermometer 

Rubber syringe 

Truss 

Cups for draught 

Listen's long outside splint 
Wooden splints for lower limb 
Sheet for operating table .... 



Tin funnel 1 

Cork screws 2 

10 gin. glass measures 2 

200 gm. glass measure 1 

Bottles for medicine shelves 5 

Dispensing bottles 6 

Ointment pots 3 

Towels 3 



A portable surgical bag and a set of dressing instruments besides the articles 
mentioned above were irretrievably damaged. 

As the cabin, wardroom, and the neighbourhood of the magazine for machine guns 
caught fire from the explosion of the shell, one half of the ship's crew were stationed 
at their assigned posts to extinguish the fire. One half of the ship's inmates being thus 
employed in putting out the fire, the supply of ammunition was interrupted, so that 
the ship almost lost her fighting power. It was therefore deemed expedient to retire 
beyond the range of the guns, so as to get time to make necessary changes in the dis- 
position of the crew, and consequently at 2 p.m., we made the following signal 
thus: — '-Our ship is on fire; leave her out of the line.'' and getting out of the line we 



; , THE BATTLE OF YAI,0. 

steered to the south-west, where 03 concentrated effort, we succeeded in putting out 
the fire at about 3.30 p.m., and now recovering our fighting power, proceeded again 
to join our squadron and resume action. We therefore steered towards where our 
deets had been, but it was now growing dark, and not only was it difficult to dis- 
tinguish our vessels from the enemy's, but as we had sustained the heavy loss of 19 
killed and '31 wounded, and. to make the matter worse, all the surgeons and muses 
being either killed or severely wounded, we had no alternative but to steer for the 
temporary anchorage near Cape Choppeki. At the time when the fire was being 
put out, three able seamen were appointed as a temporary nursing staff, and by 
these men the wounded were cared for as far as possible. Over twenty shells in all 
struck our ship, but of those not more than four caused fatal or other injuries. 
S.i far I have related what was told me by eye-witnesses. As soon as the ship 
cast anchor at the rendezvous near Cape Choppeki, she made a signal for surgeons 
to the Kaimon and the transport Doyo-maru, etc.. which were stationed in the 
vicinity. In compliance with this demand, Staff Surgeon Ishio, Assistant Surgeon 
Yoshimura and a nurse from the Kaimon, with myself and a nurse from the Doyo- 
maru soon went on board the Hiyei. On inquiring why surgeons were demanded, 
we were told that on the afternoon of the previous day the 17th, a severe fight had 
taken place between the Japanese and Chinese fleets off Haiyang island, and the 
Hiyei, having been in the thickest of t'.ie fight, had very many on board killed 
or wounded. As moreover the surgeons and nurses had been killed or severely 
injured, the wounded had been left to themselves, and we were therefore asked 
to attend them at once. Consultation was held with the surgeons from the 
Kaimon. We wished to start the indispensable treatments of the sufferers 
without delay but all the medical materials had been destroyed by the explosion of 
the enormous shell and the consequent fire, and we were compelled to send for 
ueci ssary materials from the Kaimon. A temporary surgery was established at the 
battery under the poop deck ; the sufferers Were removed there one by one, and their 
wounds temporarily dressed ; for the ship being in a greatly confused conditions, we 
could not give satisfactory treatment. So the wounds were first cleansed by washing, 
and fragments of shell or wood removed ; splints were applied to fractures and the 
wounds dressed with antiseptic bandages. This was all we could do at the time. Soon 
afterwards Surgeon Birtata from the Chiyo-maru, and Burgeon Asai from the Genkai- 

maru came on board and gave willing assistance in treating the wounded. By some 

time after one in the afternoon all the sufferers had been more or less attended to, but- 



THE BATTLE OF YALtJ. 



SI 



there were still twenty corpses piled on the poop deck awaiting examination. As it 
is of course the duty of naval surgeons to ascertain the causes of death by inspecting 
the corpses, so by permission of the Captain, we commenced about 1.30 p.m. to 
examine each of the killed on the poop deck. Their ranks and names, with the 
characters of the wounds that we perceived to have proved fatal were recorded, and 
locks of their hair cut off as mementos fur their respective families. 
The official ranks, names, and wounds of killed are as follows : — 



Names op Wounds. 


Rank. 


Names 


Mutilation of the lumbar region 


Chief Surgeon 


T. 


Miyake. 
Ishizuka. 


Mutilation of the abdominal region ... 


Chief Paymaster 


C. 




Assistant Surgeon 


C. 


Murakoshi 




1st class petty officer 
1st class steward 


K. 


Danno. 


Mutilation of both thighs 


T. 


Fujita 


Mutilation of the left thigh and right 




leg 


2nd class petty officer 


G. 


Nishiya. 


Perforated gun shot wound of chest and 








abdomen 


3rd class petty officer 


s. 


Suyehiro 


Lacerated wound of chest and abdo- 








men with mutilation of thigh 


1st class seaman 


s. 


Sunagawa. 


( lompound fracture of the face and the 










1st class seaman 


K. 


Kanai. 


Mutilation of the whole bodv . 


1 st class seaman 


H 


Shima.saki. 


Compound fracture of the forehead 


1st class steward 


K. 


Nakagawa. 


Compound fracture of the lower and 










2nd class seaman 


M 


Furuya, 


Crushed wound of the cranium 


2nd class seaman 


S. 


Arimatsu. 


Compound fracture of the face, base 








nf skull, and the upper and lower 








extremities 


•2nd class carpenter 


T. 


Oya. 


Perforated gun shot wound of the lum- 




bar region and the compound frac- 








ture of the upper and lower ex- 










2nd class nursr 


T. 


Ishikawa. 



32 



THE BATTLE OF YALt. 



Contusion of right side of chest and 

right arm and compound fracture 

of the right lower extremity 

Mutilation of the thoracic, and dorsal 

regions, ami of the lower limb. ... 

Crushed wound of the cranium 

Lacerated wounds of the lower jaw, and 

neck, and contused wounds of the 

abdominal region and the lower 

limb I 4th class seaman 

Crashed cranium ! 4th class seaman 



3rd class st. 

4th class seaman 
4th class seaman 



Y, Nihongi. 

\. Takenaka. 
M. Chikamat.su. 



S. Moroyu. 
II. Nishihara. 



After the examination, tin- corpses were in succession carefully wrapped in 
blankets and canvas. This inspection euded tit three o'clock in the afternoon. Tin 
wounded who were alive numbered 35 ; of whom 19, being considered to need treat- 
ment in the hospital, on consultation with other surg is, were removed to the 

transports. 10 to the Genkai-maru, o to the Doyo-rnaru, and 4 to the Chiyo-maru. 
On that day tin- sea was running very high, and we experienced great difficulty in 
taking them on board the transports. The remaining 17. being rather slightly 
wounded, were left to undergo treatment in the ship, which, having effected a few 

lately necessary repairs, left the rendezvous again for Haiyaug island. At 1<i 20 
p m.. the burial services of the late Chief Surgeon Miyake and nineteen others were 

menced, and tit 10.40, the ship being brought to halt, their honorable remains 
were committed to thi p at 38° 21' north latitude and 124° 23' east 

longitude. At eleven. I nisi on again, and arrived, tit noon of the 19th, 

in the vicinity of Haiyaug sland, where we sought for our squadron in vain: 
advancing further, we came to the month of the Taiyang river and cruised about 
with no bettei success; so we veered towards the Yah'i, but as night had set in, 

u changing our course, we returm to anchoragi a: half past six on 

morning of the 20th, when we found ourselves again with the Principal Squadron. 
W I] ii anchored in the station, we were visited by sn from the Hashidate, by 

whom the wounded were for a time attended and treated. However, on tie- 22nd I 
was transferred to the chief surgeoncy of the ship by order of the Chief Commander 
of the Combined Squadron ; 1 removed aboard her directly and made arrangements 
for replacing th medical materials I tight on the Yellow sea a- « i I 



THE BATTLE OB' V A l.fr. 33 

about the killed and wounded. Unfortunately the ship's medical papers wore alii 
all lost in the battle. The nine injured men from our ship that had been sent to the 
Doyo-marn and Chiyo-maru on the 18th, were again transferred by order of the flag- 
ship to the transport Genkai-maru on the 19th next, to be sent back to the Sasebo 
naval hospital. Of the sufferers thus conveyed hack. 1st class nurse S. Kato died 
on the Genkai-marn on her way home to the hospital. 3rd class steward T. Yoshi- 
hayashi and 4th class seaman J. Umimichi succumbed to their wounds in the Sasebo 
naval hospital, and the other two, 8rd class petty officer S. Suge and K. Takenishi, 
afterwards returned to the shin, having recovered at the Kure naval hospital to 
which they had i 1 moved. The rest being transferred to the charge of tb 

naval barracks, we did not hear any more reports about the progress of their wounds, 
but I believe they all quite recovered. The seventc en wounded that were treated in 
the ship all got well so that they could resume their duties aboard. 

The Yoshino. '• -At about 1.08 p.m., a 15 cm. shell pierced 
the starboard netting- (about 3.6 meters above the sea level) on the stern, 
and strikiug two of the shells for 12 cm. quick-firing gun, thai were 
placed in a row inside the netting, exploded together with the- two 
shells ;itul tore the starboard side of the quarter deck, — thai is, the 
ceiling of the wardroom. A portion of the fragments of shell dashed 
into the wardroom, another hit through one side of the wall of a 
ventilator on the same deck and struck through the porl netting, then 
striking a 1 2 cm. shell lying inside, exploded it and at the same time 
set the netting on fire. By these shell fragments a man was killed 
niit right, and Sub-Lieutenant S. Asao with 7 men on the quarter deck 
and a nurse in tie- wardroom (surgery) were wounded. 

About one in the afternoon, Midshipman T. Hirai (engaged as 
assistant to the Chief Navigating officer), in the 001110110 tower at the 
bow, got his tympanic membrane rent by the shock accompanying the 
discharge of the forecastle gun. 

2. — About 2.30 p.m., a 21 cm. Ivrupp gun (?) shell exploded 
againsl the starboard bow, e.g. the outer wall of the coal bunker 



;<4 THE BATTLE OP YALtf. 

(about .'500 m.iti. above the sea. level), the fragments penetrating into 
the bunker. Soon after the damage, a carpenter who was sent out- 
side to repair (be hole, received an injury on his fingers. 

3. — About 3 p.m., a fragment of a 15 cm. Ivrupp gun sbell 
penetrated into tbe wardroom (about 7(50 m.ni. above the sea level), — 
that is, on the starboard side of the lower deck at the. stern, and lodged 
in the mattress of the sofa on the starboard side of tbe room. It 
caused no injury to life. 

4. — A shot of a small-calibre gun perforated a hole near the keel 
in the fore part of the gig. 

5. — A fragment of a 12 cm. shell made a hole 20 cm. wide in 
the upper part of the funnel. 

• '. — A piece of a 12 cm. shell perforated the middle portion of 
the funnel making a hole of 76 m.m. width. 

7. — Three shell marks were left in the starboard waist (1.2 
meters above the sea level). 

8. — A fragment of a 12 cm. shell made a hole in the exhaust- 
steam-pipe at the rear of the safety valve. 

The Naniwa. 1- — At an uncertain time, a shot from a Hotch- 
kiss' gun reached the starboard bow (1.7 m. above the water) and left a 
conical depression on the outer plating but without penetrating. 

2. — At 1.08 p.m., a 21cm. shell struck No. 3 starboard coal 
bunker of the fore part at a point about 30 cm. below the water-line and 
made an oval hole l.L in. by 0.5 m. width, at the same time breaking a 
rib at. the spot and bending the ribs and strongers in the neighbourhood. 

3. — Time uncertain : a. shell from a 21 cm. gun tell on the sea 
near tin- starboard stern, and, rebounding, struck the starboard side of 
tbe stern (2.4 m. above tbe water), leaving a distinct mark on the 
outer plating, and broke one of the beams at thai part. It also com- 



THE BATTLE OF Y.VLUV 35 

pletely destroyed the wash-stand furnished for the use of the gun 

room officers. 

Shell fragments struck six other [daces : (a) one perforated ;i liole 
\'2() 111. in. in diameter in tin- upper part of the hammock netting at 
the rear of No. 1 side-gun on the tore pari of the starboard side ; (b) 
one made a hole 60 in. in. in diameter in the funnel, by going through 
from right to left at 6.55 in. above the upper 'leek ; (c) one pierced 
through the starboard waist (2.8 m. above sen level") and entered the 
warrant room on the lower deck where it lodged on the clothes shelf 
passing through the inner wall ; (d) one made a hole 120 nun. by 
30 m. m. in width on the starboard side of the torpedo-room at the 
stern (460 m.m. above the sea) ; (e) one made a hole LOO m.m. in 
diameter on the right and back part of the wall of the bai'bette, and 
lodged in the gun support ; (f) another hit the starboard side ot the 
stern, breaking a rivet and leaving a fissure over .">ii in. in. in width. 

During the fight. I. Kubota, Assistant Engineer in the engine 
room, slipped while al work, in consequence of a shock from tin.' firing 
of the stern gun, and got his fingers jammed in the engine, ami 
Lieutenant S. Nakamura, who was commanding the starboard battery 
had his tympanic membrane ruptured by the shock ol a gun discharge. 

The Takachiho. I. -At about 1.09 p.m., an ordinary 15 
cm. shell hit the starboard quarter (900 m.m. above the sea-level) and 
exploded. Several marks were left on the side, ami three fragments 
made holes in the side 220 or 230 in. in. in diameter, and. entering the 
room of an officer, broke all the furniture, ami eventually lodged in the 
gunsupport of the stern gun. I he tire thus cause I among the clothing 
and wooden splinters was soon put out, a carpenter, who was in the 
gun support turning the fan for the magazine, was killed by the frag- 
ments, and a cook was injured bv a wooden splinter. Another 



;*6 THE BA 1TLE "K Y.U.O" 

fra"menl ot rhe shell destroyed the ladder fixed to 1 1 »e search -light on 
tlif starboard quarter, and glanced off obliquely over the port side, and 
one more piece shattered the wheels of a field gun placed on the 
starboard just outside I he wall of the barbette of the stern gun. 

-. — Time uncertain ; a shell rebounding from the water on 
the starboard side hit the starboard quarter below the hawse-hole (1.5 
meters above the sea-level) ; owing however to its impaired force, 
nothing more than a depression was left on the outer plating. 

.">. — Time uncertain ; a shell from a Nordenfelt machine gun 
perforated a scuttle of the cabin on the starboard side. 

I. Time uncertain ; a -pent shell rebounding from the water 
caused a depression above the torpedo-tube hole in the fore parr of the 
starboard (1.35 meters above the sea level). 

5. — lime uncertain ; a shell from the starboard side destroyed 
the bottom of No. 1 cutter on the starboard booms of the after part 
on the upper deck (4.5 meter- above the sea-level), and then shattered 
No. 1' 'inter nil the port side. No person was injured. 

A fragment of a shell cut asunder one of the whip- for the use of 
the main-top ; and at ."> p.m., a gunner ol No. 4, 15 cm. side gun on 
the port side of the waist deck had his fingers injured, while firing, 
by the gun gears. 

The Akitsushima. 1. — At 1.09 p.m., a 21 cm. common 
shell struck the upper part of the shield of No. 5, 1_ cm. gun on the 
starboard waist of the upper deck (4.2 meters above the sea-level), and 
exploded. The flying fragments killed or injured as follows : 

A gunner and three >>t the crew ol the above gun, and Lieutenant 
IT Nagata commanding officer of the port battery, then standing by 
No. 6, 1- cm. -Tic uun were killed outright ; and one of the crew of 
No. .">. \~2 cm. port gun, a gunner and two of the crew to No. 6, 17 m.m. 



THE BATTLE OP YAI.O ;J7 

port 1:1111; three ammunition men near No. 5, 1- e.m. starboard gun 
and n stoker near the hatch of the fore engine room were wounded. 

2. At about L.50 p.m., the fragments oi 21 cm. shell damaged 
the starboard cutter, the hammock netting of the haul davit belonging 
in the cutter, the wall plates of the gun gear store below the conning 
lower, the glass window of the chief navigating officer, the rails of 
the ladder to the bridge and the hammock netting of the haul davit of 
No. 2 cutter, but did no injury to men or officers. 

3. — About 2.10 p.m., a broken piece of a 15 cm. shell (20 cm. 
long N cm. thick) penetrated the outside plating of the hammock 
netting oi the starboard waist (4.2 meters above the sea level) where 
it was stopped owing to the presence of coiled ropes within. 

4. — At 2.45 p.m.. a 1 ."> cm. shell penetrated, on the pott side of 
the lower part of the shield of the stern gun on the poop deck 
(5.76 meters above the sea level), and broke a part ol the (leek and tin- 
starboard shell stand. At tin- time, a gunner of tin" battery wsis 
wounded by a wooden splinter of the deck. Later in the action, at 
1.30 [1. m.. a stoker was thrown off the steps of the engine room by the 
-hock of a firing gun and received injuries on his chest. 

Tlie Aka°i. '• — Al about 1.15 p.m., a .">7 m.m. shell crushed 
the outside plating and cleat behind No. •"> q.f.-gun on the starboard 
side of after pari (1.95 meters above the sea level) and passed off toward 
the port side. At the time, one of the crew oi No. fi q.f.-gun on 
the port side of the after parr of the upper deck was injured h\ r a 
bra 'ken piece of iron. 

2. — About 1.20 p.m., broken pieces of an ordinary shell from the 
starboard beam struck the bridge and wounded Lieutenant 11. Sasaki, 
a signal man. and a blue-jacket belonging to No. 2 q.f.-gun, who 
ware then on the bridge. 



38 THE BATTLE OF VA1.C. 

■\ — About 1.20 p.m., fragments of an ordinary shell came from 

t lie starboard side and passed away to the port side through a hole in 
the shield of No. •>. 12 cm. gun on the waist deck. At the time, one 
of the crew of the above gun was injured by a piece of the shell. 

4. — About 1.20 p.m., a 57 m.tn. Hotchkiss shell came from the 
stiirboard beam and struck the inclined part of the shield of No. 3, 
12 cm. gun, without piercing through it; hut it only left a depression 
where it struck and benl the square irons attached thereto. 

5. -At 1.22 p.m., a 47 m.m. Hotchkiss shell passed over the 
foretop, where it killed Midshipman I. Hashiguchi and wounded a 
top musketeer. 

(3. — About 1.25 p.m.. a 15 cm. shell that fame from the stern. 
struck t lie inner part of the starboard side below the bridge, and burst 
(not exploded) against No. 1 q.f.— gun support, and broke it. 
The fragments oi the shell killed Captain 11. Sakamoto and two of the 
crew <>f Xo. 1 q.f.— gun, all ot whom were then on tin- bridge, and 
injured two others of the crew of the same gun. Almost at the same 
moment, a signal man who was also on tin- bridge was wounded by a 
( rat ling shot. 

7. — About 1.25 p.m., a 12 cm. shell exploded and knocked 
through the side below the water-closet on the starboard bow (300 

m.m. above the sea-level). The fragments flying about the fore part 
of the lower deck, killed four fire-brigade men ami injured one. 
Further the steam pipe opening to the ventilating fan was honey- 
combed by the fragments. 

8.- I Set ween 1.25 and 1.30 p.m.. shell fragments came flying 
from the starboard beam and glanced away to the port side, grating 
off in its course the bark wall of the water-closet in the fore part of 
the upper deck. Three men who were then working at the Downton 
pump in the lot'*- part of the upper deck were instantaneously killed. 



THE BATTLE OP YALC. 39 

!\ — At 1.30 p.m., a 15 cm. shell knocked through the outside 
plating below the captain's water-close! on the .starboard after quarter 
of the upper deck, and breaking a part of the closer passed oft' to the 
port side tearing three plates of the upper deck ami stripping off the 
sky-light in its course. No harm to any person. 

lit. — At 1.30p.m., a shell fragment came sweeping from the 
starboard side of the after part, and passing by the lower part of the 
shield of Xo. 3 q.f— gun on the starboard side of waisl deck, wound- 
ed three of the crew of that gun. If then glanced to the port bow of 
the upper deck where it wounded a petty officer. 

11. — A.bout 1.35 p.m., a 12 cm. shell grated off the vicinity of 
the hinge of the door of the port-hole of the stern gun (Xo. 4, 12 cm. 
gun), 1.5 meters above the sea-level, and went off to the port side. 
breaking the ventilator in the after part of the sky-light. Xo damage 
to any person. 

12. — About 1.40 p.m., a .">7 m.m. shell made an oval hole in the 
outside plating at some 450 m.m. above the spot on the starboard 
j of the after part which had been struck by the ninth shell and 
broke another part of captain's water-closet and then tore three 
hammoeks provided tor the protection of the sky-light of the cabin, 
before dashing off to the port side. 

1 .'i. — At 1.40 p.m., five or six shell fragments came from 
the stern and passing by the left side of the shield of the stern 
12 cm. gun, went awav to the port-side. At this time, two of the 
crew of No. 5 q.f. -gun, who were then on the starboard after quarter 
of the upper deck were wounded by small pieces. 

14. — Between 1-2 p.m.. a fragment of a shell pierced through 
the door of the port-hole of Xo. 2. 12 cm. gun in the tore part of the 
upper deck (about 1.2 m. above sea). Xo injury to persons. 

15.— About the same time as above a fragment of shell struck 



40 



THE BATTLE OV YAT.0 



the starboard ash shoot (1.2 meters above the sea-level) without 
causing any apparent damage. 

111. —Time saint- as above a shell of small calibre struck the first 
cutter suspended to the davit, on the starboard side of the after 
quarter, and exploded without any injury to life. 

17. —Between 1.30—2 p.m., tour or five shells above 12 cm. in 
size, '"Hue dashing from the starboard beam at one time, and striking 
the main-mast cut it into three. They also split tin- spanker-gaff and 
ton- the starboard rigging to pieces, without causing death or injury 
to persons. 

18. -Time same as above, a shell struck the second cutter, 
suspended from tin- davit on the port side oi the after quarter, and 
damaged its gear and outside plating. No death or injury. 

19. — About 1.40 or 1 .50 p.m. , a 57 m.tn. Hotchkiss shell pierced 
the upper part of the funnel, from starboard to port (7.5 meters above 
the sea-level) and passed away. 

'20. — Aboul 2 p. in., a 57 nun. Hotchkiss shell came from the 
.-tern, and striking through the left side of the shield of the stem 12 
Cm. gun. exploded there, damaging the regulator of the gun, and 
wounding a gunner of the same gun. 

21. — At 2.15 p.m., a 15 cm. shell coining from the stern, struck 
the starboard nettings near the bridge and glanced off toward the 
bow. At the moment. Chief Navigating officer T. Sato was wounded 
bv a broken piece oi metal and a wooden splinter. 

22. — Between 2— 2..'>t> p.m.. several pieces of an exploded shell 
impressed S marks on the port door ol the stern 12 cm. gun. 

i'.'i. —Time as above. A fragment of 17 cm. shell broke the 
starboard side of the gallant forecastle and lodged in the bollard heads. 

24. lime as above, a 37 in.tn. Hotchkiss shell pierced through 
the foremast, at point of fJOO m. in. below the top and Hew off forward. 



C 



THE BATTLB OF YALtj. 41 

25. — Time as above, a (ratling shell (?) damaged the nettings on 
the bridge, impressed several marks on the search light, and smashed 
the 1 lens. 

26. — Abonl 2.30 p.m., a 57 m.m. Hotchkiss shell hit through 
the outside plating, and the port door at the left side of No. 5 
j.f'.-gnn on the starboard side of the after quarter, (about 1.2 
meters above the sea level), and broke three plates of the upper deck, 
causing if to leak. It then glanced off to the port side, causing no 
injury to persons. 

27. — Time uncertain ; a 37 m.m. Hotchkiss shell pierced through 
the swinging boom placed against the starboard rigging, and tore the 
latter asunder. 

28. — Time uncertain ; a 57 m.m. Hotchkiss shell knocked a hole 
through the lower part of the funnel (4.5 meters above the sea level), 
that is, about 1.5 meters above the casing and passed away. 

29. — Time uncertain ; a 37 m.m. Hotchkiss shell struck into the 
shield of the stern 12 c.m. gun, without piercing it. 

30. — Time uncertain ; a 47 m.m. Hotchkiss shell(?) came Hying 
from starboard beam, and striking the barrel of No. 1 quick-firing gun 
on the starboard of the bridge, only left a depression. 

In addition to those above mentioned, Nordenfelt or Gatling 
shells left numerous marks on the nettings of the bridge; and several 
perforations were made by the fragments of a shell at the top of a 
ventilator, opening to the engine room on the starboard side of the 
waist, and other small fragments left their marks on the back of the 
foremast. 

At the battle of the Yellow sea this warship was one which was reduced almost 
to the last extremity, oue-third of her complement being killed or wounded including 
Captain Sakamoto who fell a victim to a hostile shell. Sin.' was no more than a 
gun-boat, her medical staff consisting of only a chief surgeon and a nurse. The 



42 THE BATTLE OF Y&L&. 

difficulties experienced by them in executing their duties can hardly be imagined. 
From the following report on medical work during the engagement furnished by K. 
Usui, Chief Surgeon of the ship, we shall be able to 3 ie how the medical department 
of the ship was managed. 

On September 16th 1894, our ship set out from the temporary anchorage at Cape 
Choppeki, together with the Main and First Flying Sguadrons, and arriving at Hai- 
yang island on the forenoon of the 17th, reconnoitred the interior of the bay of 
that island ; and at Tai-ku-shan, she descried the enemy's fleet in the distance. At 
0.20 p.m. she took her position for action, and opened firing at 1.09. Owing to the low 
rate of her speed, we fell behind the main body during the battle, and being thus se- 
parated, naturally became the object of the enemy's concentrated attack. We were 
indeed once, in a very precarious condition from which it took a great deal of hard 
fighting to extricate ourselves, and rejoin the main squadron. Herewith I have the 
honour of reporting my personal experiences of medical work during the combat. 

The surgery of the vessel during the time of action had been prepared in the 
fore part of the lower deck, but owing to its nearness to the magazine, and to the 
fact, that there was no partitioned place to admit the passage for ammunition suppliers, 
it was necessarj to get a safe place below the water line e.g. cock-pit ; but this being 
too narrow, and inadequate for the surgery, the Captain gave us permission to use 
his cabin as a surgery during the battle. The table in the middle of the cabin was 
made into an operating table; the benches on both sides of the ship and the stairs 
above them serving as bed-steads. The skylight was (dosed and protected with 
hammocks, so that lighted candles had to be used. A short time after our prepara- 
tions were finished a shell fell on the upper deck, and injured four of the guncrew. 
Before their dressings were finished, the firing on both sides grew hotter and hotter ; 
and the wounded were being brought in one after another, when all at once a gun- 
shot destroyed the ceiling of the surgery (upper deck), and glanced away. At. 1.25 
Captain Sakamoto and two of the guncrew were killed on the bridge, ami two others 
were wounded. After this the wounded that were brought in from the upper and lower 
ileck^. were so numerous that we could not spare much time to any one individual. 
We could therefore only apply tourniquets to the wounds, and let slightly wounded 
men resume their duty, keeping only the serious eases in bed. At last by '2.30 p.m. 
the firing abated, and the wounded were each in his turn placed on the table ; and the 
character of each wound being well . jammed, the fragments of shell, pieci 
iron and wooden splinters remaining in the wounds extracted. Presently the firing 



I UK BATTLE OF YAM':. 4;-j 

utirely, aud we proceeded to detailed operations. I may here remark though 
many shells strnck around the surgery, yet happily none of thani exploded in the 
surgery, aud so our operations were not hindered at all. Most of the wounds were 
caused l>y shell fragments, death being in many cas ss instantaneous ; but none of the 
cases which came under treatment resulted iu death. The wounds were mostly 
contused lacerations, sometimes accompanied by fractures. Tbe edges of the wounds 
were often ragged, and at first not accompanied with much bleeding, as though the 
stoppingof haemorrhage had taken effect, but iu a few hours, bleeding came on iu several 

-. Happily however tie- large blood vessels were iu uocasetorn, though the surfaces 
of the wound were extensive. The method of treatment was uniform ; — that is, a 
strictly antiseptic method ; with the wounds having regular edges ; sutures were tried ; 
with the deep, large, irregular ones, iu which primary union could not be expected, 
drainage tubes were introduced after adjusting the edges, and the wounds left open 
with blind wounds in which the in! all small, these were enlarged for the 

convenience of examining and extracting fori ign b idies, and at the same time with a 
view to preventing any accumulation of the discharge afterwards. For probing the 
wounds for foreign bodies, fingers proved to he the best. The penetrating pieces of 
shell or iron, etc., were all irregular masses full of angles and apt to harm the sur- 
rounding tissues whilst being extracted. In time of battle, men are greatly excited 
and full of spirit, so there were very few casc-s in which an ancesthetic was needed. 
A violent shock was only found in one case of a wound in the i 

By noon of the 18th, the treatment of all tie- sufferers bad been finished in a 

ral way. Of the killed and wounded mentioned above, 11 were killed outright and 
17 wi i. We then took the wardroom, as a temporary hospital, aud serious 

case-- were removed there. On examination the temperature showed a rise iu every 

and the margins of the wounds exhibited signs of inflammation. On the 19th 

the temperatures showed an inclination to go down. On tbe same afternoon, the 

bandages were changed, and 10 serious cases sent on board the Genkai-Maru for the 

Staval Hospital. The remains .if the killed had on the 18th been cremated 

on laud, when oar ship returned to ■ ■ >nj, river. 



•14 



I HK BATTLE OF Y \!,(\ 



'HE KILLED ARE AS FOLLOWS. 



X.\ M K.S. 


Offices, 


Pl-ACKS WHKRK 

I'lll'.V Wl'KK 
iN.IIKKIt. 


Name- ok Wounds, 


1 II IRACTKRS OK WOUNDS. 


oto. 


Captain 


i . : idge 


Severance of the head. 


Mutilation ol head, except face 
and the base of the cranium. 


['. Kafthigm-hi. 


Mid*l ipman 


Fore- top 


ed wound of 
the lumbar i i 
with fracl ure oi \ er- 
tebrae. 


The lumbar vertebra and pel- 
vis fractured : the spinal 
coi i and aorta ruptured ; 
the intestines protruding. 


M. Hamada. 


Jiinmrchu t carpenter 


Lower deck 


i i in t rated wound of 
the cranium ; rup- 
ture "f the abtl i- 

nal region. 


The right temporal region 

.. , | i 

and bladder coming out of 
■ i >wcr abdomina 


K, Y:i£u< kit. 


.1 iniior cliief black-smith 




Smashing of tin 


i lie head entirely smashed, 
leaving a pari ■ i occiput 
and low er jaw. 


It. Miyai ■ 


1 .i -- seaman 


The briilge 


. 1 [jotll 


i - sei i red, 
.•.I wii h leg ■■ ' ml; hj small 
flaps oi skin. 


S. Watanabc. 


i lass seaman 


I o\i er deck 


i'i rforat ion oi cranium. 


!.. ft i arietal bone : 
and a shell lodger] in crani- 
um. 


T. Mats ■ 





Upper ileck 





Right t< inporal bone pi 
and a shell lodged in brain. 


M 1 itihnchi. 


■ 


I.- w< «" di ek 


i ..... 
the lumbar regit n 
with fracture of the 
vertebrae. 


The lumbar regi n pierc 

ed, lumbar vertebra frac- 
tured .and many perforated 
ids found on 1 ■ 


1 . i ■ .i rii 


2nd cLl* • 


1 ppel . 


Severance i 1 - 


The upper half of the head 
■ ed, leaving the lower 
half of the occipul at level 
with the base i t uose. 


s. Kusuki. 


3rd class -.'.mi m 


ri ie bridge 


Severance oi tin 
thigh and the right 
side of pelvis. 


The righl thigh severed at the 

rig lit -i'i.' of pelvis .. i 
ral vessels t< in. 


k ma. 




0] leek 


Perforated wound of 

. iiiinm. 


■ i ■ ■: iddle "i 



1 1 'ill. mi I- r.. ! wound or wounds of each stated here. ' 



For the conveyance oi 1 1 it* wounded, hands were chienj relied upon, for in a 
small ship like this. it. was only descending a stair-case of 8 " shaku" at 20 ken 
from the remotesi part of the bow, that the snrgerj could he reached. So it was far 
better to have the task done promptly with hands, than to waste time over providing 
apparatus. Besides, the use of stretchers in narrow places during the time ol action 
is cumbersome. However, 1" convey the wounded from the fore pari of the lower 
deck tn the surgery al the rear, thej had both to ascend ind descend the stairs, as 
owing i" il e presence of the engine room in the waist, they had first to ( le to the 

. deck from tin fori part of tin li n e di els a ud thei i nfter pai t ol 



THE BATTLE OF YALtf. 4o 

the lower deck, where the surgery was stationed. In this case, they were ordered to 
use truck-stays (an ohlong canvas with poles passing through its ends) or simply to 
carry the wounded on the hack by means of a rope. 

At first there were only two bearers, who worked with great assiduity, but later 
on in the action as the numbers of the wounded increased, it was felt that they wi re 
not sufficient to meet the emergency. For, deafened by the roaring of the guns, and 
consequently unable to catch the customary signals and cries for help, they had to 
take the trouble of hurrying about in search of the sufferers. In my opinion, at least 
four carriers for every hundred men should be provided, it being always possible that 
the carriers may themselves be injured. During the hottest part of the battle, cook- 
ing can not actually be carried on, so all the stewards and cooks might take the duty 
of carriers. On consultation with the Captain, it was decided that henceforth in our 
ship the carriers should consist of a steward and four cooks assisted by six tackle-men. 
Again, in a hard fight like this, in which so many were wounded at one time, it was 
extremely difficult for one surgeon to give prompt and proper treatment to all, 
especially in the case of wounds requiring complicate operations with the administra- 
tion of an anaesthetic. 

Another matter that attracted our attention during the engagement was the 
great need of water. Whether the climate be cold or hot, men get exceedingly thirsty 
from over-exertion, and drinking water should therefore be abundantly provided on 
such occasions. In our ship during the preparations for the fight, copper vessels or- 
dinarily used for serving boiled rice had been filled with water and placed at each 
gun. Besides this, a large quantity was required for washing wounds, etc., and it 
must be remembered that the quantity of combustible material, such as canvas, and 
wood, brings with it a great danger of conflagration which necessitates a liberal 
supply of water for its extinction. 

The Saikio Mam. L— At 1.14 p.m. two 30.5 cm. shells 

that came at the same moment, between the starboard main 
riggings, smashed the wardroom and several adjoining rooms, and then 
piercing through the port side, fell into the water some 20 meters off 
the ship's side. 

2. — At 2.22 p.m. a couple of 30.5 cm. shells rebounding from 
the water about 200 meters to the starboard, passed through the ward- 



46 THE BATTLE OF YALu". 

room. One of them, breaking a starboard ventilator, exploded in front 
of the wardroom, smashing it as well as several other adjoining rooms, 
with the sky-light, hatch, and all the furniture ; the other split the 
steam- pipe and water-pipe connected with the steering gear, and pass- 
ing just under the upper deck, pierced the deck, went through a cutter, 
and at last fell overboard. At the time, Chief Surgeon K. Tawara, who 
was at the entrance of the hatch to the wardroom, was thrown down 
on the stairs by the shock of the explosion and wounded. Also a 
captain's servant and a stoker, who were then at the same place, and two 
oil men. who were at the hatchway of the engine room, were slightly 
injured by wooden splinters. 

;!. — About 2.2 4 p.m.. two shells, one of 12 cm. and the other of 
21 cm. at the same time reached to the wardroom on the upper deck, 
from the starboard side, but passed away without exploding or pro- 
ducing any special damage. 

4. — About 2.30 p.m., a 15 cm. shell struck against the last boat- 
davit on the starboard quarter splitting it in two, and exploded there, 
shell fragments, broken iron pieces, wooden splinters flying in every 
direction over the uppermost deck. A quarter-master and two men 
of the 57 m.m. q.f.-gun, were injured. 

5. — 2.30 p.m., two 12 cm. shells came from the starboard side 
and pierced the funnel. 

6. — About 2.36 p.m., a 15 cm. shell struck the .-hip at the water- 
line on the starboard side of the after part, but it had not >ufficient 
force to penetrate through the side, only leaving a crack which let in 
a little water. 

7. — About 2A0 p.m., a 12 cm. shell, rushing in by the -tern, 
exploded against a stanchion in the after part of the main deck. This 
terribly damaged the adjoining rooms, and set them on fire. It was 
however soon extinguished. 



THE BOMBARDMENTS OF TAXOCHOW. 47 

8. — About 2.42 p.m., a 12cm. shell (?) came from the starboard side 
and tore off the fore mast derrick. At the time, three of the gun crew in 
the fore part of the upper deck were injured by splintered wooden piece.-. 

Besides the above mentioned, several shell marks were left on the 
bowlight stand, fore-mast, flag-staff, chief engineer's room, funnel 
casing, main mast, ventilator and funnel. They were all certainly 
caused by shells from small calibre guns or by shell fragments. 

3.-THE BOMBARDMENTS OF TANGCHOW. 

Tangcbow was three times bombarded ; the first bombardment being made by 
the Yoshino. Naniwa, and Akitsushima of the First Flying Squadron, on January lSth 
and 19th, 1895. The enemy's forts replied to the bombardment with gnus of small 
calibre and about 60 pounders. One of the 60 pounder shells, fired from a fort on Tang- 
chow promontory, flew over the Yoshino, but all the rest fell short of our ships which 
sustained no damage. 

The second bombardment was attempted by the Tenryu and Kaiinon, belonging 
to the Third Flying Squadron, on the 26th of the same month ; the Kaimon then 
received two shells : the one was a bomb-shell which burst over the ship, slightly 
tearing the ship's flag ; the other was a shell from an eight cm. field-gnu which struck 
the upper part of the after-davit of the starboard galley, and, there exploding, broke 
the iron-band of the davit stay, cut off the boat-haul and injured the galley ; at the 
same time one of its fragments grazed past the chest of a gunner at No. 5 gun, tearing 
his clothes, but doing no farther injury. 

The third bombardment of Tangchow was made by the three battle ships ; 
Tenryu, Yamato, and Musashi on the 21st of February. The enemy's forts replied 
to the attack with field gnus and 12 cm. guns ; some of the shots fell in front or rear 
of the Musashi, but none struck any of our ships. 

4-THE ATTACK ON WEI-HAI-WEI. 

From January 30th, 1895 the entire force of our Combined Squa- 
dron with the torpedo-flotillas belonging to them, made several attacks 
on Wei-hai-wei. The forts of Lieukung and Zhih islands assisted by 



48 



THE ATTACK OX WEI-HAI-WEI. 



the Chinese fleet in the port made a desperate but fruitless defence. 
On February 12th the enemy surrendered to our fleets. In this service 
our vessels were not all equally engaged : some served only a day, 
while others were engaged for several days in successive engagements. 
Consequently the damages sustained varied with each vessel. AVe 
subjoin lists of the numbers and ranks of the officers and men on board 
each vessel : of the dates when they were engaged in the fighting, 
and of the amount of damage sustained on each occasion. 

OFFICERS AND MEN OX BOARD EACH VESSEL. 



Name of Vessel. 


-j. 

z 


09 

- 

Z 

a 
z 


EC 

z 



m 


a: 
« 

DC 
< 


z 

< 

m 


K 

c 


•J, 

it 

z 

Si: 


8 g 
: v. 

ic < 
< H 
S L 

> X 

— < 


i- 


Matsusliima 


33 


11 


4 


3 


277 


74 


3 


22 


427 


Itsnkusbima 


25 


1(1 


3 


2 


229 


74 


3 


18 


3G4 


Hashidate 


24 


10 


3 


2 


229 


74 


3 


18 


3G3 


Yosliino 


28 


12 


2 


3 


251 


101 


3 


22 


422 


Naniwa 


24 


10 


2 


o 


224 


78 


3 


18 


301 


Takaelrilin 


23 


10 


2 


2 


224 


78 


3 


18 


360 


Akitsushima 


23 


10 


2 


2 


l-o 


85 


3 


18 


323 


Chiyoda 


21 


8 


2 


2 


185 


76 


3 


18 


315 


Tsnkuslii 


1", 


i'i 


2 


2 


93 


48 


2 


14 


182 


Banjo 


5 


3 


1 


2 


G3 


21 


1 


11 


107 


Maya 


5 


3 


1 


2 


60 


25 


1 


8 


105 


Atago 


6 


3 


1 


2 


GO 


25 


1 


8 


10G 


Cliokai 


G 


3 


1 


1 


GO 


25 


1 


8 


105 


Akagi 


G 


3 


1 


2 


SI 


25 


1 


9 


128 


(The above formed the Standing 
Squadron.) 




















FltSO 


30 


7 





3 


280 


G7 


3 


21 


413 


Hiyei 


19 


G 


o 


2 


214 


44 


3 


17 


307 


Kongo 


19 


6 


2 


2 


214 


44 


3 


17 


307 


Takao 


lti 


7 


2 


2 


138 


17 


2 


14 


228 


Yamato 


15 


:. 


2 


2 


158 


36 


2 


14 


234 


Katsuragi 


14 


6 


2 


2 


158 


3G 


2 


14 


234 


Mnsashi 


15 


5 


2 


2 


15S 


36 


2 


14 


2:: 1 


T,i. ryu 


13 


5 


2 


.> 


i::;: 


32 


2 


14 


203 



THE ATTACK OX WEI-HAI-WEI. 



49 



Eaimon 


14 


5 


2 


2 


130 


32 


2 


14 


201 


(The above formed tile Western 
Sea Squadron.) 




















Kotaka 


3 




™ 


_ 


12 


13 


— 


— 


29 


No. 5 boat 


3 




. 





5 


7 


— 





10 


No. G boat 


3 










5 


7 








16 


No. 7 boat 


3 








. 


5 


7 








15 


No. S boat 


3 




__ 





5 


7 








16 


No. 9 boat 


3 










5 


7 





— 


16 


No. 10 boat 


3 







. 


5 


8 








17 


No. 11 boat 


3 










5 


8 








17 


No. 13 boat 


3 






. 


5 


7 








10 


No. 14 boat 


3 










6 


7 








17 


No. 18 boat 


3 









5 


7 








16 


No. 19 boat 


3 









5 


7 








16 


No. 21 boat 


4 




. 


. 


C 


8 


— 


— 


18 


No. 22 boat 


4 










7 


8 








20 


No. 23 boat 


4 










7 


8 








20 


(The above formed the Torpedo- 
flotilla.) 




















Landing party to Lu-) 
ebohtsai forts . . . ) 


4 


— 


— 


— 


58 


— 


— 


— 


62 


Total 


451 


107 


45 


48 


3,945 


1,299 


52 


349 


G,356 



NOTE - 



Originally tbe Banjo's complement was 114, the Maya's 10G, tbe Tenryii's 217, 
the Kaimon's 214, but 7 from the Banjo, 1 from the Maya, 14 from the Tenryu, 13 
from the Kaimon, were sent to Luehohtsai as a landing party, therefore the above 
numbers were subtracted from the original numbers in each ship so that in the table 
we give 107 in the Banjo, 105 in the Maya, 203 in the Tenryu, 201 in the Kaimon, 
and the landing party despatched to Luehohtsai forts numbered G2 by the addition of 
27 men from the three ships Yayeyama, Amagi and Oshima, to the 35 men from 
the above mentioned four vessels. 



50 



THE ATTACK OX WEI-HAI-WEL 



BOMBAEDMENT ON JANUARY 30th, 1895. 


Name of S 


-up. 


Place of Attack. 


Records. 


Hiyei 




Zhih island 




Kongo 




ditto 




Fuso 




ditto 


Compressor of a gun 


Takao 




ditto 


damaged. 


Kaimou ... 




Off Kinshantsai 




Tenrvn 




ditto 




Banjo 




ditto 




Yamato ... 




Eastern entrance of Wei-bai-wei 




Katsnragi... 




ditto 




Musashi ... 




ditto 




A kagi 




ditto 




Maya 




ditto 




Atago 




ditto 




Chokai 




ditto 




Tsukusbi ... 




ditto 




BOMBAEDMENT ON FEBRUARY 3rd, 1895. 


Hiyei 




/hih island 




Kongo 




ditto 




Takao 




ditto 


Slight damage of the shin. 


Tsukushi . . . 




ditto 


Damaged: some killed 


Fuso 




/hih and Liukung islands 


and injured. 


Yamato . . . 




ditto 




Katsnragi... 




ditto 




Musashi ... 




ditto 




BOMBARDMENT ON FEBRUARY 5th, 1895. 


Chokai ... 




Zhih island 




Atago 




ditto 




BOMBAEDMENT ON FEBRUARY 7th, 1895. 


Matsusbima 




Eastern forts of Liukung island. 


Damaged ; some injured. 


Cbiyoda ... 




ditto 




Itsukushiina 




ditto 




1 [asbidate 




ditto 


Damaged. 


Yoshino ... 




ditto 


Damaged ; some killed or 


1 1 iyei 




ditto 


injured. 



THE ATTACK OX WEI-HAI-WEI. 



51 



Takacbibo 


Liukung island 




Naniwa 


ditto 


Damaged. 


Akitsusbima ... 


ditto 


Damaged ; some wounded. 


Kongo 


Zbib island 




Takao 


ditto 




Fuso 

Kaimoii 


ditto 
ditto 


Damaged ; some of the 
crew wounded. 


Tenryu 


ditto 




Yamato 


ditto 




Musasbi 


ditto 




Akagi 


ditto 




Tsukushi 


ditto 




Maya 


ditto 




Atago 


ditto 




Cbokai 


Zbib and Liukung islands 




BOMBAKDMENT OX FEBRUARY 9th, 1895. 


Kaimoii 


Zbib island 




Tenryu 


ditto 




Yamato 


Eastern forts of Liukung island 




Katsnragi 


ditto 


Some sligbtly injured. 


Musasbi 


ditto 




BOMBARDMENT ON FEBRUARY 11th, 1895. 


Kaimoii 


Eastern forts of Liukung island 




Tenryu 


ditto 


Damaged ; some killed or 
wounded. 


Yamato 

Katsnragi 


ditto 
ditto 


Damaged. 

Damaged ; some of tbe 
crew killed or wounded. 


Musasbi 

Hiyei 

Takao 


ditto 

ditto 
ditto 


Sligbtly damaged. 


Fuso 


ditto 




Naniwa 


Kwang island 




Akitsusbima 


ditto 




BOi 


IBARDMEXT OX FEBRUARY 12th, 1895. 


Naniwa 


Kwang island 




Akitsusbima ... 


ditto 





52 



THE ATTACK OX WEI-H AI-WKI. 



THE NUMBER OF SHELLS HIT AND OF THE KUiLED 
AND WOUNDED. 

(Of the torpedo-boats, the Kotaka received 1 or 2 rifle-bullets, No. 6 boat over GO, Xo. 10 ; 10, 
Xo. 23 ; 3 or 4, but a> the injury was not noticeable in any case, no statement will be 
made in the table ) 



Name of ship and 


1>ATS OP 


Number of 


Number of 


Xbmbh: ■ >i 


Total of 




BOMBARD- 


shells 




THE 


THE KILLED 


BOAT. 


MENT. 


RECEIVED. 


THE KILLED. 


WOUNDED. 


OR WOC NDI D 


Matsusbima 


1 


1 




3 


3 


Itsukusbima 


1 





— 


— 


— 


Hasbidate 


\ 


1 


— 


— ■ 


— 


Yoshino 


1 


1 


•2 


5 


7 


Naniwa 


3 


1 




— 


— 


Talcacbiho 


1 





— ■ 


— 


— 


Akitsusbima 


3 


1 


— 


2 


2 


Cbiyoda 


1 





— 


— 


— 


Tsukuslii 


3 


1 


1 


7 


8 


Banjo 


1 





— 


— 


— 


Maya 


•2 





— 


— 


— 


Atago 


3 





— 


— 


— 


Cbokai 


3 





— 


— 


— 


Akagi 


•2 





— 


— 


— 


Fuso 


4 


1 


— 


7 


7 


Hiyei 


4 





— ■ 


— 


— 


Kongo 


3 





— 


— 


— 


Takao 


4 


1 


— 


— 


— 


Yamato 


5 


■2 


— 


— 


— 


Katsuragi 


4 


i 


1 


7 


8 


Musasbi 


5 


1 


— 


— 


— 


Tenryu 


4 


1 


5 


G 


11 


Kainion 


4 




— 


— 


— 


Kotaka 


1 




— 


— 


— 


No. 5 boat 


1 


— 


— 


— 


— ■ 


No. ti boat 


1 


1 


— 


— 




No. 7 boat 


1 





— 


— 




No. 8 boat 


1 





— 


— 




No. 9 boat 


1 


13 


1 


4 


8 


No. 10 boat 


1 


— 


— 


— 


• — 


No. 11 boat 


1 


— 


— 


— 


— 


No. 13 boat 


1 


— 


— . 


— 


— 


No. 14 boat 


1 


— 


— 


— 




No. 18 boat 


1 


— 





■ — 




No. I'.t boat 


1 


— 


— 


— 


— 


No. 21 boat 


1 





— 


— 


— 


No. 22 boat 


1 


— 


3 


2 


5 


No. 2 3 boat 


1 


— 


— 




— 


Lucbob tsai torts. 


14 


3 


4 


3 


7 


• ll 


92 


30 


20 


4,; 


in; 



THE ATTACK" OX WEI-HA.I- WEI. 53 

As will be seen from the above table, the number of shells that hit 
our ships from the enemy's forts (forts of Liukung and Zhih islands) 
during the attack on Wei-hai-wei was just 30, by which 66 persons 
were killed or wounded. The courses of these shells, and the damage 
done by them, are as follows. 

In the Tsukushi. While firing upon Zhih island on Feb- 
ruary 3rd, about 1.20 p.m., a 24 cm. shot (?) that came over the port 
beam, struck through the lower part of the funnel (1.8 meter above the sea 
level), rent the upper deck of the starboard side, entered the scullery on 
the lower deck and passed through the starboard side. The raking mis- 
sile shattered the bundles of iron poles for tents which were stacked on 
both sides of the funnel, the broken pieces of which, driven off in all 
directions, damaged a <nir and a boat bun"- on the starboard side of the 
upper deck, killed one of the gun crew of the 9-pounder who was on the 
left side of funnel, and wounded two men on the right side of the said 
place so badly that they succumbed in the course of the day. Moreover, 
Assistant Paymaster Koike on the port side of the upper deck below the 
bridge and Midshipman Yotsnmoto at the fore part of starboard side of 
the upper deck, a man of the port machine gun in the fore part of the 
upper deck and one of the crew of the starboard 9-pounder in the middle 
of the upper deck were wounded by the flying iron fragments. When 
the shot dashed through the kitchen a cook was wounded by the 
iron and wooden splinters. 

Ill the TakaO. During the attack on the forts on Zhih 
islaud, about 0.07 p.m., on the same day, a 12 cm. shell severed the 
lower part (about 4.5 meters above the sea level) of the middle shroud 
of the port main rigging, breaking the metallic gears. 

In the Matsushima. During the attack on the eastern 



54 THE ATTACK ON WEI-HAI-WEI. 

forts on Liukung island, at about 7.40 a.m. February 7th. 1895, a shell 
of about 24 cm. that fell on tbe sea. some 200 meters off the port bow, 
rebounded and, battered tbe chart, box, and mantelet upon tbe fore 
bridge, grazed tbe steam-pipe, knocked through tbe middle of the 
funnel, broke the awning' stanchion outside the 1st port cutter, ridge- 
chain, the chain of the cutter-davit, aftermost haul, and upper block, 
the awning stanchion and awning ridge chain of the fore bridge, the 
foremost funnel-stay on the port side and the rail of the fore bridge, and 
then glanced away. Chief Navigating officer of the Combined Squad- 
ron, E. Takagi, Assistant Navigating officer 1!. Ishii, who were on the 
fore-bridge at the time, were injured, the former by wooden splinters 
and the latter by tbe grazing of the shell; and Midshipman 
S. Mori, who was in tbe conning tower, was injured by a flying iron 
fragment. 

In the Hashidate. During the attack on the eastern forts 
of Liukung island on the same day at about 7 a.m., fragments of a 24 
cm. shell which exploded on the .-ea to the port side, damaged the out- 
let cover of the torpedo tube in the port bow (610 m.m. above tbe 
sea level). 

In the FUSO. During the attack on the forts on Zhih island, 
about 8.40 a.m. a 12 cm. steel-shell from a quick-firing gun, not 
furnished with an explosive, pierced tbe starboard side of the gallant 
forecastle, where it broke up and smashed the ladder. The head of 
the shell passed through the bellows on the fore part of the upper deck, 
hit the middle of the conning tower withoul passing through it, and 
rebounding dropped on the deck. Unt; of the crew of No. I shorl 7.5 
cm. gun who was at his post, a man of the magazine party, a stretcher- 
hearer, who was then hclow the starboard side of the forecastle, one of 
the crew nf No. 2 Hotchkiss ffun who was near the bellows on the 



THE ATTACK ON WEI-HAI-WEI. .-,;, 

upper deck, and one of the crew of No. 1 Hotchkiss gun, who was on 
the bollard heads on the starboard side of the forecastle, "were injured 
by shell fragments. A petty officer who was on a step of the ladder 
on the starboard side of the forecastle, and a signal man. who was 
on the starboard side of the foremast, were wounded by wooden 
splinters. 

In the YoshinO. During the bombardment of the eastern 
forts of LiukunL r island on the same day, at 8.05 a.m.. a shell that re- 
bounded from the sea some 100 meters from the port beam, split the 
shield of Xo. t> 3-pounder above the middle part of the port netting 
(4.8 m. above sea level). One half of the shield being blown off 
shattered the bottom of Xo. 2 cutter which was stowed on the booms 
above it, knocked down the stanchion of the flying bridge and lodged 
on the deck-house. Other fragments of the broken shield, flying in 
every direction, scathed several parts of the upper deck and damaged 
the walls of the deck house, while tin.' shell itself went away without 
exploding. Two of the crew of Xo. 6 3-pounder were instantaneously 
killed by the broken pieces of the shield ; and one of the crew of the 
same gun, a gunner, ami two men serving Xo. 6 12 cm. gun, were 
wounded: a man belonging to the same gnn was iniured bv the broken 
handle of an oar in Xo. 2 cutter. 

In the Naniwa. While bombarding the fortresses on Liu- 
kung island on the same day, at 8.12 a.m.. a 24 cm. shell struck the 
ship at a spot a little below the coaling hole in the middle part of the 
port side (1 meter above the sea level), making an aperture .'300 
m.m. in diameter, and destroyed in succession the inner tube of the 
coaling hole, two of the deck plates in the room of the chief boatswain, 
18 plates on the starboard side of the lower deck, the greater part of the 
chief carpenter's room, the flag-box furnished inside the starboard side 



5(3 THE ATTACK OX WEI-HAI-WEI. 

and the coaliug hole in the middle part of starboard side. The shell 
itself however glanced off to the starboard side without exploding. 
Not a man was killed or wounded. 

Ill the Akitsushima. During the bombardment of Liu- 
kung island on the same day. about 9.10 a.m.. a 15 cm. shell crushed 
the stanchion extending from the poop-deck to the bridge (5.6 meters 
above the sea level) and exploded on that deck, when one of the crew 
of No. 7 nun, who was standing at its breach, and one of the crew of 
the stern gun, who was then at its side, were wounded bv the exploded 
fragments. 

In the Yailiato. During the bombardment of the eastern 
forts of Liukung island on February 11th, about 11.10 a.m., two 12 
cm. steel shells (?) came at the same moment from the port bow at an 
angle of 30° with the long axis of the ship, the falling angle being 40°. 
One split the port after main-brace, and swept between the bridge and 
its tent, then destroyed the Nordenfelt gun on the starboard side of 
the bridge, and fell with it in a mass into the sea. The other piece 
pierced the galley suspended from the starboard davit, a little behind 
the middle part of the ship, and fell into the sea. Neither missile did 
any injury to persons. 

In the Musashi. During the firing upon the eastern 
fortresses of Liukung island, about 11.15 a.m., a shell flew past over 
the ship, cutting off the starboard main brace on its way. 

In the KatSUragi. While she was bombarding the eastern 
forts of Liukung island on the same day, aboul 9.15 a.m., a 24 cm. 

shell hit ih- barrel of the b »w gun (about 3.2 meters above the 
sea). One third of the barrel was broken off and thrown into the sea; 
at tin- -one time, the shell was broken into fragments which damaged 



THE ATTACK OX WEJ-HAI-WEl. 57 

a half of the gun port and utterly destroyed the provision-store of the 
wardroom where a part of the broken pieces lodged. The other por- 
tion of the fragments killed one of the crew, and wounded another of 
the same gun, who were then at its side. Five others of the crew of 
the gun, were wounded by the shattered wooden splinters ; but happily 
the shell did not explode with violence, as it was not provided with 
an explosive. 

Again, while firing upon the eastern forts of Liukung island, 
Lieutenant S. Kurita had his left foot run over by a gun wheel which 
recoiled from the shock of firing. 

In the Tenryu. During the bombardment of the eastern 
forts of Liukung island on February 9th, about 11.10 a.m.. a 24 cm. 
steel-shell passed obliquely through the after part of the port hole of 
No. 2 12 cm. gun on the middle part of the port side (about 3.2 
meters above the sea level), and then fairly striking the mounting of 
the gun, exploded. Several fragments that flew in all directions, 
smashed the sky lights of the engine room, broke the upper deck for a 
space of 4.2 meter long, 2.4 meter wide, split two beams, fractured the 
lower part of the main-mast, tore an area of 1.8 meter in the starboard 
booms, crushing various implements stored therein, wrought slight 
damage in the covers of Nos. 1 and 2 hatches, rent the rails of Xo. 2 
hatch, and bent those on the right side of the bridge, besides various 
minor damages to tackles and boats. The fragments that entered the 
lower deck destroyed the doors around the engine room and that of 
the boatswain's room, and broke the 7-inch Downton pump at the rear 
of the lower deck. At the same time,, the fragments killed Commander 
S. Nakano on the starboard side of the conning tower of the bridge, 
a petty officer and three of the gun crew on the starboard side of the 
middle part of the upper deck and wounded three men who were all 



58 THE ATTACK OX WEI-HAI-WEI. 

on the upper deck. The iron and wooden .splinters injured Assistant 
Engiueer T. Takano then in the engine room, and a man of the fire 
brigade, then on the middle part of starboard side of the lower deck. 
Moreover, an ammunition supplier, then in the after cock-pit on the 
lowest deck, got contused by a falling piece of the severed brass rod 
belonging 1 to the rail of the hatch. 

When the above mentioned shell reached the ship, only the bow 
gun happened to be firing. The side guns having suspended action, 
the gun-crews were dismissed for the time being, and consequently 
though the shell struck the mounting of Xo. 2 side gun and exploded, 
yet not one of its crew was injured, nor any one belonging to the other 
side guns. The rudder wheel was protected by a wall of large ropes, 
so the dispersed fragments could not do any harm to the wheel men 
nor to the rudder-wheel. 

As regards the landing-party from the Tenryu, Kaimon, Amagi, 
Banjo, Yayeyama, Oshima and Maya that had been sent beforehand 
to the occupied fort of Luchoh tsai at Wei-hai-wei, during the firing 1 
on the enemy's squadron anchored in the port of Wei-hai-wei : — on 
January 30th, 1895, about 4.30 p.m., a 30.5 cm. shell from the Chinese 
vessel Ting- Yuen struck the barrel of the 24 cm. gun on that fort and 
exploded; thus tearing the gun. The fragments of the exploded shell 
and barrel killed two men, and injured two. Xext. during the bom- 
bardment on February 3rd, about 1 p.m.. a shrapnel fired from the Sai- 
Yueti, exploding in front of that fort, killed a warrant officer, and a 
petty officer. Again, on February 7th, at the fort, while a seaman was 
on picket-duty, aboul ,S in the morning, a shell exploded at a distance 
of 2 meter- from him. lie was knocked over and received a wound in 
his righl loot. 

Night attacks by tin- torpedo-boats were made twice, on February 



THE STORMING OF THE PESCADORES. 59 

5th and 6th. Of the tea boats— Nos. 5, 6, 8, 9, 10, 14, 18, 19, 21, 
and 22 — which constituted the attacking flotilla on the 5th, No. 9 

boat received 13 shells large and small. Of these, a shell that 
struck her at 4. .'!0 a.m. fairly struck the boiler and broke it ; the steam 
and boiling water gushing out of it, scalded eight persons belonging 
to the engineering party, of whom four died on the spot, two others 
expired in the course of that day and the next ; and the remaining 
two happily recovered. About 5 a.m., on the same day No. 22 boat 
got aground on a reef on her return from the attack, and being in the 
last extremity, Sub-Lieutenant T. Suzuki and a seaman plunged into 
the sea intending t<> swim ashore, but their limbs were so numbed by 
the cold that they were drowned. Two seamen and a stoker had their 
canvas boat upset while attempting to reach the shore: the stoker was 
frozen and drowned ; the other two managed to reach the Luchoh tsai 
fort in the possession of our army, but one man of them afterwards 
died from the long exposure to the cold. The other survived but suf- 
fered severelv from frost bite. On the same day No. 6 boat received 
1 machine gun shot and more than sixty bullets, and Xo. in boat 10 
bullets. 

In the attack on the 6th day. the Kotaka received 1 or 2 bullets 
and Xo. 23 boat 3 or 4 bullets. However, none of these missiles caused 
any noticeable damage to the boats, and there was no injury to men. 

5.-THE STORMING OF THE PESCADORES. 

On March 23rd, 1895 the Matsushima, Hashidate, Itsukushima, 
Xaniwa. Takachiho, and Akitsushima belonging to the Combined 
Squadron arrived at the Pescadores, convoying five transports with a 
detachment of the army on board. They began by storming the 
Kon-peh-tai fortress on the south side of the islands, to which the 



(]0 BOMBARDMENTS OX OTHER PLACES. 

enemy replied by tiring their heavy guns. The battle lasted nearly rive 
hours and resulted in the silencing and almost entire demolition of the 
enemy's fortresses. Meanwhile, the army detachment landing at 
Liseikaku in the main island advanced far into the interior. At dawn 
on the 24th, a landing party was sent from each warship to assist the 
army, and on the 25th, the enemy offering to surrender, the entire 
island was subdued. 

Throughout the engagement, our fleet received no injury. How- 
ever, a seaman belonging to the landing-party was wounded by the 
aimed shot of an enemy, while reconnoitring a native house at the 
Seishi-an village on the main island. 

6.-B0MBARDIYIENTS AT OTHER PLACES. 

Having finished the statements of the battles recorded in the sections 1 to 5, we 
ought now properly to report on the actions at Hwa-yuan-kow, Talien-bay, Port 
Arthur, Yin-shan Bay, and Keeking, Takow, Anping in Formosa. But as during 
these fights our warships suffered no injury that needs to be recorded, we will refer 
our readers fur fuller particulars to other official papers. 



CHAPTER II. 



BRIEF HISTORY OF THK KILLED AND WOUNDED. 



1. INJURIES EXTENDING OVER THE WHOLE BODY. 

1.— Mutilation of the whole body :— M. Taniamura, aged 33, crew of No. 
7 Hotchkiss gun of the Matsnshima ; in the battle of Yellow sea, on September 17th, 
1894, he whs firing on the fort of the gnu on the starboard side of flying deck, amid- 
ships, when a shell exploded against the mounting of the gun ; he was struck by the 
large fragments of the shell and iron pieces, so that Ins whole body was smashed to 
pieces, death being instantaneous. 

2. — K. Shima, Lieutenant of the Matsnshima, aged 30 years ; in the same battle 
lie was commanding the battery on the fore part of the lower deck when a 30.5 cm. 
shell burst against the shield of No. 4 side-gun on the port side of the same deck, 
and, at that moment the ammunition provided for the side-gun was ignited, so that 
by the explosion his whole body was smashed to pieces. 

The following 24 cases of mutilation of the whole body, on board the ship 
Matsnshima, were caused by the same explosion as above : 

3. — M. [to, Sub-Lieutenant, aged 27 years, while commanding the battery on 
the fore part of the lower deck. 

4. — K. Shigeta, petty officer of the Matsnshima, aged 38 years, while standing 
along the fore battery ou the lower deck. 

5. — T. Maki, a gunner of No. 1 starboard side-gun on the lower deck, while 
standing by the gun. 

('). — K. Matsumoto, crew of No. 1 side-gun. 

7. — T. Terada, crew of No. 1 side-gun. 

8. — C. Ognsa, crew ut No. 2 port side-gun. 

0. — S. Takesh ita, a gunner of No. 3 starboard side-gnn. 



62 INJURIES EXTENDING OVEB THE WHOLE BODY. 

1". — il. Ikeda, crew of No. 3 starboard side-gun. 
11. — T. Fukuma, crew of No. 3 starboard side-gun. 
12. — S. Nakamura, crew of No. 3 starboard side-gun. 
13. — K. Yamashita, a gunner of No. i port side-gun. 
14. — K. Nakamata, crew of No. 4 port side-gun. 
15. — K. Amagoi, crew of No. 4 port side-gun. 
16.- -S. Tanaka, crew of No. 5 starboard side-gun. 
17. — G. Ninakawa, crew of No. 7 starboard side-gun. 

18. — I. Sasaki, crew of No. 9 side-gun, while near tin magazine on the lure part 
of the lower deck. 

19. — T. Hayashi, a fore magazine man, while lifting the ammunition from the 

magazine on the lower deck. 

20. K. Miyazato, a fore magazine man, while lifting the ammunition from the 
magazine. 

21. — S. Takagi. a tore magazine man. 

22. -Y. Masuda, a fore magazine man. 

•23. — G. Yamaguchi, a fore magazine man. 

24. — J. Azuma, a lore magazine man. 

25. —J. Kondo, a hand man, while acting as a bearer of the wounded, beneath 
No. 1 hatch on the fore pai t 

26.- -Y. Yoshida, a band man, while acting as a bearer of the wounded, beneath 
No. 1 tore hatch. 

'27. — EL Sbimasaki, crew of No. 9 gun of the Hiyei, aged 29 years. In the 
same battli oi the Yellow sea, lie was on the fort of No. it gun, at the stern, where he 
was engaged in tiring, when at about 1.18 p.m., a shell pierced through the alt and 

upper part of the stern port. The flying wooden splinters, inflicted a contused wound 

on tie- lead, and be came down to the surgery in the ward-r i on the lower deck. 

While he was 1\ ing on tie- deck another hostile shell exploded in that room. A huge 

fragment of the shell crushed Ins whole body. 

28. — T. Sanno, crew of No. 5 side-gun of the Akitsushima, aged 28 years. In 
the same battle of the Yellow sea, he was on tie- fori ol No '< side-gun on the 

Starboard of the waist-deck, when at 1.09 p.m., a shell hit the shield of the same 

gun ainl exploded. \ large fragment of the shell smashed in-- whole uodj to 
piei - 



INJURIES OF THE HEAI' (',:; 

•29 -Lacerated wounds in several parts of the body with burns of 
whole body : — K. Danno, petty officer of the Hiyei, aged 30 years. In the same 
battle of Yellow sea, he was acting as a carrier to bring the wounded on the upper 
deck to tlie surgery on the lower deck. While he was standing in the room a 30.5 cm. 
shell pierced through the starboard side of the stern and exploded there. He received 
serious lacerated wounds all over the head, face, trunk and limbs, and was burnt 
almost all over the body. 



2— INJURIES OF THE HEAD. 
(A). [NJUEIES OF THE SCALP. 

30. — Abrasion of the scalp : — U. Nishiya, aged 24, one of the torpedo-crew 
of the Itsnkushima. On September 17th, 1894, he was on duty in the fore torpedo- 
chamber of the vessel, in the battle of the Yellow sea, when a shell exploded against 
the boom of the starboard torpedo-net ; the fragments pierced through the ship's side 
into the chamber, one of which gave him an abrasion 1 cm. long at the upper part of 
the right frontal eminence. Dry corrosive gauze was applied to the abrasion. On 
the 21st of the same month, he was sent to Sasebo Naval Hospital. On admission 
the lesion was almost dry, and in a short time healed under scabbing. He left the 
hospital on October 1st to resume sen i 

31. — Y. Yamamoto, aged 21, one of the Hotchkiss gun crew on the port side of 
the Hashidate. In the engagement of the Yellow sea, he was on the hatter;, of the 
said gun in the fore part of the upper deck, when a shell hurst in the turret of the 
how -gun : one of the fragments made an abrasion 1.5 cm. long, at a point 3 cm. 
behind the right mastoid process of the occiput. Dry corrosive gauze was applied 
and the wound healed by .scabbing within a few days. 

32. -M. Ogawa, aged '25, Sub-Lieutenant of the Hiyei. In the battle of the 
Y'ellow sea. he was passing the fourth quarter of the starboard side on the lower deck 
to superintend the tire brigade, when a 30.5 cm. shell exploded in the ward-room, in 
the fifth quarter. Some of the fragments indicted a small abrasion, below the 
occipital protuberance, and several others, which were dotted like scattered grains, on 
the left side of the face and the back of the left hand. The wounds soon healed up 
under corrosive gauze. 

33. — K. Miyamoto, aged 20, one of the gun crew of the Hiyei : In the battle of 



(54 INJURIES OF THE HEAD. 

the Yellow sea, he was engaged in firing No. 8 gun on the port side of the quarter deck, 
when a shell pierced the ship's side just behind the port hole of No. 7 gun. A wooden 
splinter inflicted an abrasion, 2 cm. long, just above the external occipital pro- 
tuberance. The wound was dusted with iodoform, dressed with corrosive gauze, 
and healed by scabbing in a few day-. 

34.— Contused wound of the forehead : — H. Sagara, aged 32. senior car- 
penter oi the Matsushima. In the battle of the Yellow sea, while on duty as one 
of the fire brigade, he was passing the fore part of the lower deck, when a 80.5 cm. 
shell exploded against the shield of No. -1 gun mi the port side of the lower deck, one of 
the fragments inflicted a contused wound about 2 cm. in diameter on the middle part 
of the forehead. In depth it reached to the periosteum, hut the bone was not injured. 
Alter temporary dressing in the vessel, he was admitted on the 20th of the 
month, to Sasebo Naval Hospital, when granulation had already commenced so as 
to cover the surface of the periosteum without formation of pus an antiseptic bandage 
was applied ; the wound healed favourably and lie was discharged on the 22nd of 
i October to resume service. 

35. — Y. Tanaka, Sub-Lieutenant of the Hiyei, aged 20. In the battle of the 
Yellow sen. ;i shell exploded in the ward-room and set the aft lower deck on tire. He 
was commanding the fire brigade near the stern battery, at the time when another 
shell broke through the starboard side of tin -tern, and one of the wooden fragment- 
injured him with a contused wound on the right side of tin ion head. As all the 
surgeons of the vessel had already been killed, he had to apply a bandage to the 
wound himself: first medical aid he received was from the surgeon of another vessel 
when tiie Hiyei arrived next morning at the rendezvous, near Cape Choppeki. There 
was an irregular contused wound on his forehead, a little to the right of the median 
line, which did not injure the muscle or bom .- carbolic gauze was applied. On the 
30th of the month, the surface of the wound was wholly covered with skin, but the 
epidermis was still thin and delicate, an elastic collodion was applied to tin pari and 
bj October 12th it bad completely healed. 

::,; Contused wound of the forehead with abrasion of both forearms ; 

— K. Kurokawa, one of the crew of No. 7 side-gun of the Matsushima, aged 26 years. 

'■< month-. At the time of tin . i ■■. incut off the Baiyang islands, on September 17th. 

1894, be was standing near to the starboard No. 7 gun on the lore pari ol the lowi 

when a 80.5 cm. shell exploded against the shield of the starboard No. 4 gun 



INJURIES OF THE HEAD. Qtj 

oil the same deck. Some of the small fragments inflicted several contused wounds : 
one 2 cm. long at a point immediately above the occipital protuberance, another 10 
cm. long on the left side of the forehead, and a smaller one 3 cm. long on the front 
part of the upper portion of the right fore-arm. There was also an abrasion on the 
outer side of the upper portion of the left fore-arm. Previous to this event, he had 
been under medical treatment for pleurisy which presented signs of aggravation after 
the injury. He was ordered to have rest, and corrosive gauze was applied to the 
wounds. On the 20th of : the month, he was sent to the Sasebo Naval Hospital. 
The wounds of the head then healed up by scabbing ; on the right fore-arm pus was 
slightly discharged : the wound was washed with sublimate lotion and dressed with 
corrosive gauze. Physical signs of the chest revealed dulness on the lower part of the 
right Mile, feeble respiratory sounds and diminished vocal thrill but the temperature 
was normal. Iodide of potassium was given. The wounds were completely healed 
by October 5th. 

37.— Contused wound of the left parietal region :— K. Miyata, aged -24, 

one of the crew of No. 9 side-gun in the Matsushima : On September 17th, 1894, he was 
standing by No. 9 gun-battery, on the starboard side of the fore part of the lower deck, 
when a 30.5 cm. shell exploded, hitting the shield of No. 4 side-gun on the port side 
of the same deck. One of the fragments, inflicted a small contused wound 2 cm. 
long and 1 cm. wide which was so superficial as not to reach beyond the cuticle. It 
was directly sealed with corrosive gauze and healed by scabbing by the 29th of the 
same month. 

38 —Contused wounds of the left parietal and left lumbar regions : — 

1>. Kobayashi, aged 21 years .1 months, one of the crew of No. 4 gun of the -Hiyei : 
in the battle of the Yellow sea while tiring the No. 4 side gun on the port side of the 
waist-deel;, a shell came over the netting of the starboard waist, and broke through a 
pinnace and a steam launch on the booms, and exploded against the stanchion of the 
booms on the port side . Some of the iron and wooden splinters inflicted a contused 
wound of the size of a 5 / /// copper coin at a point 4.5 cm. above the left ear. The 
wound was superficial and did not pierce the pericranium. There were also small 
contused wounds on the left loin. They were dressed with corrosive gauze, and the 
patient was. on the 19th next, taken aboard the transport Genkai-maru bound for 
home and was admitted to the Sasebo Naval Hospital on the 21st of the same month 
At that time the wound of the head was forming a scab and those of the loin 



CP, INJURIES OP THE HEAD. 

invented granulation with a slight discharge of pus. As a result of injury to the head 
there was anaesthesia and paralysis of the right side of tlie face, so that lie could not close 
the right eye nor protrude the tongue perfectly. Speech was consequently difficult : 
there was also paresis of the extremities of tin right side. This was perhaps owing 
to the fracture of the inner plate o, the parietal bone. Alter admission to the 
hospital the wounds were dressed antiseptiealiy. and iodide of potassium was given 
internally. On the 90th he was removed to the Kure Naval Hospital where he was 
completely cured of the wounds as well as the paralysis and left the hospital on 
December 6th to resume his duty. 

39 -Contused wound of the right parietal bone and contusion of the 

right shoulder: — K. Hera, aged - JS years 11 months, a seaman of the Saikyo- 
maru : in the battle of the Yellow sea while he was tiring, 47 m.m. q.f. gun on the 
port side oi tin' loir part of the upper deck, at the hostile torpede-boats, a shell flew 
in from the starboard side, and tore off the derrick of the fore-mast, a wooden 
splinter injured him on the head and shoulder. On examination, there were 
superficial contused wounds on the right parietal region and over the spine of the 
right scapula. Iodoform was sprinkled on the head wound and spirits of camphor 
was applied to the scapula. The wounds healed by the Hist. 

4ii.— Contused wound of the right temporal region :— Y. Shimizu, aged 
30 years and 8 months, a gunner attached to the No. 7 gun of the 1 liyei : whili be was 
in the battery of No. 7 gun on the starboard side of the quarter deck, engaged in tiring 
at hostile vessels in the same battle, a shell perforated the bulwark jusl behind the 
gun-port, the wooden and iron platings being thus smashed. One of the wooden 
splinters inflicted a contused wound 1.5 cm. in length, 1 Nil. in width, and 1.5 C .m 
in depth, which ran down towards the back from the fore and upper pari of the right 
temporal region. Bleeding was not profuse, the temporal artery having escaped injury. 
Corrosive gauze was applied ; and by the 20tli of the same month, a small spot of 

suppuration was found on the surface of the wound : granulation however was red 

and well developed. The wound was washed with carbolic lotion to remove the 
pus and then covered with corrosive gauze Bj the -loth, the surface of the wound 
had diminished in size and by October 2nd, had healed by cicatrization. 

II. K. Takenishi, aged 21 years 10 mouths, seaman of the Hiyei : in the battle 
■ i t-lii Yellow i a, hew: ei I as a magazine-man in lifting shells at the entrance 



INJURIES OF THE HEAP. 67 

of the magazine in the third quarter of the lower deck, when a tremendous shell ex- 
ploded in the ward-room. One of the flying pieces inflicted a contused wound on 
the upper margin of the right temporal region. Though the wound reached the bone 
yet there was no fracture. However, the tips of the left fingers were affected with 
anaesthesia and paresis. The patient, after temporary treatment in the vessel, was 
admitted to the Sasebo Naval Hospital on the 21st of the same month, where after 
some days the pain of the wound was much relieved. When lie was removed to the 
Kure Hospital nine days afterwards, the wound of the scalp was almost covered with 
newly developed skin, leaving a mere spot of granulation at the centre, but the 
numbness of the lingers still continued though much diminished. The surface of the 
wound was anointed with zinc ointment and a mixture of iodide of potassium given 
internally. On October 6th, the wound healed by scabbing, followed by a subsidence 
of the paresis of the fingers. By October 10th, he had completely recovered and 
left the hospital to resume his former service. 

^2— Contused wound of the right mastoid region :— I. Fnkazawa, aged 

24, an oil man of the Saikyo-maru, in the same battle with the above, was stand- 
ing near the entrance to the engine-room as a relief-hand, when two 30.-"> cm. 
shells entered the ward-room on the upper deck and simultaneously exploded in front 
of the ward-room on the port side. Fragments of the shells and pieces of wood were 
pushed about, one of which inflicted a wound on the head just over the mastoid pro- 
cess. On examination the wound was found to be shallow and the bleeding and pain 
very slight, iodoform was sprinkled over it and it was covered with adhesive plaster. 
It had healed by scabbing by tl.e 20th of the same month. 

43- — Gutter wound of the left parietal region : — M". Kawamitsu, aged 

20, a magazine man of the Hiyei : during the battle of the Yellow sea, he was working 
at the entrance of the magazine under the lower deck, when a 30.5 cm. shell ex- 
ploded in the ward-room, one of the fragments came crashing through the deck and 
inflicted a wound on his head. On examination a groove wound 3 cm. in length, 1 
cm. in width and in depth was found on the right parietal region. It was irregularly 
lacerated on its edges presenting a ragged appearance, at the bottom of it an 
irregular wedge-shaped fragment of the shell, of the size of a bean, was perceived but 
the bone was intact. The fragment was extracted and an antiseptic dressing applied. 
On the 28th of the same month, granulation developed and the discharge of pus had 
almost ceasi d. On October 8th, the wound healed up by a cicatrix. 



,; s [JfJURIES OF THE HEAD. 

44. — Penetrating wound of scalp and neck ; burns of face and 
neck: rupture of both tympanic membranes :— N. Kususe, aged 31, tor- 
pedo crew in the fore part of the [tsukushima. In the same battle witli the last, he 
was busily loading tbe torpedo in the chamber, when a shell explode, I against the 
boom provided lor the use of the torpedo-net on the side, some of the shell fragments 
that entered the torpedo-chamber inflicted several injuries upon him: two contused 
wounds, one "> cm. and another 2 cm. long, over tin- sagittal suture of the skull. 
These were not deep enough to pierce the oeeipito-l'roiitahs ; but in the wounds small 
fragments of the shell wen- found and extracted. He got a superficial burn too, 
extending from the right side of the head to the right half of the face and down to a 
part of the neck : grains of powder intruded into the skin, the hair was also scorched. 
Again, there was a small wound below the right mastoid process : when probed, a 

foreign body was found which, being extracted, turned out to he a wooden splinter 3 
cm. long. An antiseptic dressing was applied, and the patient was sent to Sasebo 
Naval Hospital on the 21st of the same month. On examination in the hospital, 
perforation of the membrana tympani of both ears besides the said wounds was 
discovered. He was removed to Kure Naval Hospital. The wounds ,il the head 
healed at the beginning of November, but the lesion of the membrana tympani 
remained up to the middle of December, leaving the thickenings of membrana 
tympani ami dulness of hearing. On December 23rd, he left the hospital to resume 
his service. 



I.VJUKIES OF THE HEAD. 



69 



(B). INJURIES OF THE HEAD ACCOMPANYING THE 
FRACTURE OR CEREBRAL LESIONS. 

45.-Compound fracture of forehead :— 0. Yamakawa, aged -25, a maga- 
zine man of the Fuso. During the bombardment of Zhili Island on February 7th 
1895, he was standing under the starboard forecastle, when a shell exploded through 
the gallant-forecastle, some of the Hying pieces of the shell inflicting three lacerated 
wounds on the forehead : the first about 
6 cm. long parallel with the right eye- 
brow; the second 1.5 cm. long near the 
margin of the hair in the middle of the 
toirhrad : the third 4 cm. long en the 
part a little to the left of the second one. 
Through the wound lacerated cerebral 
substance streamed out together with 
venous blood which probably came from 
the venous sinuses inside the skull. The 
frontal bone was badly severed. He 
uttered only one or two words at the 
time the blow was received and im- 
mediately became unconscious, stertorous 
respiration was present exhibiting symp- 
toms of compression of the brain. An- 
tiseptic dressings were applied, and he 
was placed in perfect rest; but expired after two hours and a half from coma. 

On post-mortem examination, the frontal bone was found to be irregularly 
cracked with a lacerated hole ; the internal table was seriously severed and some of 
the fragments being free, the anterior fossa of the cranium was seen to be heavily 
mutilated (See illustration No. 1.) 

-n>.— Compound fracture of forehead and left forearm : -K- Moriya, 

aged 28, crew attached to No. 6 three prmuder of the Yoshiuo. While bombarding the 
eastern fort of Liukung island on February 7th, 1895, a shell hit against the shield 
of No. ti three pounder lying on the port netting of the waist deck. The fragments 




Fig. 1. — Cracks in the fori 



70 INJURIES OF THE HEAL'. 

of the mutilated shield destroyed the upper half of his frontal bone and mutilated the 
left forearm. He died on the spot. 

■17.— Compound fracture of forehead with burns of face: — U. Hattori, 
I 31, a petty officer of the Hiyei. During the engagement in the Yellow sea, be 
was standing at bis post at the relieving-tackle m the cabin on the stern of the lower 
when a shell burst in the next ward-room, splintering the walls and deck, 
lie sustained a lacerated wound, running obliquely upwards from the upper part of the 
left orbital ridge; at the same time he got a burn from the exploding flame which 
extended over the right half of the face. All the surgeon's of the vessel having being 
killed by the same shell, he had to be temporarily dressed by his mates, and received 
treatment for the first time on the following morning when the vessel east anchor in 
th< station near Cape Choppeki. The condition of the wounds was a-- follows: the 
laeeratedwound on the left side of the forehead was 7 cm. long in S-shape, in depth it 
reached to the hone, resulting in the crack of that hone. The burn on the right half 
of the face was of the first degree. The patient complained of a marked loss of the 
left eye sight. Antiseptic dressing was applied, and he was sent to the Sasebo Naval 
Hospital on the lilst of the same month. When examined on admission, the pupil of 
the left eye was dilated and the haemorrhage of the retina was found to be such that 
objects could hardly he distinguished by the patient. 

A wet compress of horacic lotion was applied to the eye ; a carbolic gauze to Un- 
wound of the forehead, and horacic acid and olive od to the hum. The hum healed 
on the 13th day following, ami the head wound was almost healed, hut the symptoms 
of the left eye remained unchanged. He was removed to the Kure Naval Hospital 

and on October 7th, the sight of the left eve had somewhat improved, the vision 

•20 
showing TTrrr^ 1 "! the visional field being 12" above, 15 .7 below, 13 .8 outward and 

11 .5 inward. The fundus presented marked hemorrhagic patches. The vision of 

the right eye was not much interfered with hut the field was markedly contracted 

viz: 1-1 .7 above, 17 .1 below, 17 .7 outward and 16°.8 inward. Thewound of the 

forehead was contracting by the development of granulation: internally, iodide of 

potassium was administered. From that time thewound gradually healed up with 

an ugly cicatrix on the left forehead. However, the sight of the hit eye was not im- 

•_>u 
proved, the vision still remained -r-^, so that the fingers could hardly be counted at 

a distance of I feet; the field of vision was decreased to 20 (above), 30 (below), 30 

(inward), and 20 (outward). Thus being disabled for the service, he was invalided 



tNJOBIES <>F THE HEAP. 7] 

on February 4tli 1895 for life. He was. according bo regulations, granted a 
pension. 

48— Compound fracture of the left parietal bone:— E. Isobe. aged 
26, captain's steward of the Hashidate. At tlie time of the battle of the Yellow 
be was assigned the duty of stretcher-bearer, while standing at tbe left side of the 
turret of the bow-gun, a shell burst in it, one of the fragments inflicting a lacera 
wound 3 cm. long, over tbe left parietal eminence. The wound reached down to tbe 
bone, separating the periosteum and breaking the outer table of the hone, but with- 
out cerebral symptoms at all. An antiseptic dressing was applied; the patient was 
-iiit to the Sasebo Naval Hospital on the 21st. At the time, edges of the soft part of 
the wound were lacerated, and a tree fragment of hone was recognised at the bottom. 
So the hair of that part being shaved and antiseptic precaution being taken, the 
sequestrum was extracted ; an iodoform gauze was applied ; and the case pro- 
gressed favourably. By October 22nd, granulation had developed so as to wholly 
over tin' bone, and by November 20th, the pas discharge had entirely ceased ; granu. 
lation grew smooth and contracted, ointment of boracic acid was applied ; and the 
cicatrix formed on December 10th. He hit the hospital completely recovered on 
the 14th of the same month. 

49.— Compound fracture of head and right upper extremity with 
penetrating wound of abdomen:—^. Asao, aged 27. Sub-Lieutenant of the 

Yoshino. In the battle of tbe Yellow sea. he was standing in the stern of the 
upper deck, on the port side, in command of shell carriers, when a hostile shell 
came through the starboard netting and hitting two 12 cm. shells arranged on the 
deck exploded all three at once. One of the flying fragments struck him in tbe 
middle of the forehead breaking the bone as follows : — length 15.5 cm., width fi 
cm. and extending to the vertex over the coronary suture : a part of the brain 
escaping from the wound. Other fragments inflicted two contused wounds, each of 
the size of one sen copper coin : one about the middle of the outer side of the right 
upper arm, and one on the hack of the right elbow joint breaking the olecranon 
process and the internal condyloid eminence of the humerus. Again, a penetrating 
wound 3 cm. in diameter was inflicted on the left side of tin epigastric region. He 
became unite unconscious ; respiration was feeble, indicating little vitality. He was 
taken directly to the surgery on the lower deck and given perfect rest, hut he expired 
about an hour after the accident from coma. 



72 INJURIES OF THE BEAD. 

•")ii.— Compound fracture of the forehead :— M. Yamashiro, aged 28, a man 
of No. 6 three pounder in the Yoshino. During the bombardment of the eastern fort of 
T, inkling island on February 7th, 1895, he was standing by the side of No. 6 three- 
pounder on the netting of the port side of the waist, when a shell struck against the 
shield of the gun. The shell itself did not explode, but the shield was smashed into 
pieces. One of these pieces inflicted a lacerated wound in the middle of the coronary 
suture : the hone of that part and the left orbital plate were fractured, the brain was 
crushed, and the man killed on the spot. 

51 -Compound fracture of the head, face and left upp t arm with 
contused wound of chest and left leg:— K. Ushijima, aged 21, a seaman of the 
Yoshino. At the time of the engagement in the Yellow sea, September 17th, 1894, 
he was standing, as a shell-carrier, between the right and left ventilators on the upper 
deck of the after quarter, when a shell pierced through the starboard netting and 
>tnking against two 12 cm. shells placed side by side on the inner side of tie- 
netting. All three shells exploded at once. One of the fragments, inflicted a 
fracture of the frontal bone 6 cm. long aud 3 cm. wide which ran obliquely from 
the left side of the forehead to the region over the coronary suture. Brain substanci 
came out of the wound and he died on the spot. Besides, there were found 
many other contused wounds, some with fracture: several on the forehead, one over 
the left canthus, another over the right corner of the mouth, and others over the 
middle of the chin and on the right malar region ; the face was blackened all over 
by the explosion of the gas. On the chest again, there were several others reaching 
down to the ribs. There were also: simple fracture at the middle of the left 
humerus, a compound fracture of the left forearm, and burns of both lees with a 
lacerated Wound on the outer side ot the left leg. 

52. Contused wound of forehead with a fracture of the base of the 
cranium : — K. Odajima, aged 19, a cook of the Fuso. In the attack on the forts of 
Zhih island on February 7th, he was standing under the starboard forecastle as 
carrier of the wounded, when a hostile shell passed through the gallant-foi castl 
and burst, tie was wounded on the leftside of tie- forehead. It was a crescent- 
shaped lacerati I vouud 6.5 cm. long, running from a point about 8 cm. above the 
outer end of the superciliary ridge, upward and inward; it terminated beyond the 
margin of the hair. At the bottom of the wound, the periosteum was stripped off, 
but the bone was left intact. The wound was sutured with two stitches, and an 



< 



INJURIES OF THE HEAD. ,:! 

antiseptic bandage was applied. After a short while, epistaxis and bsematemesis 
occurred suggesting a fracture at the base of the cranium. At first, the mind was 

clear but afterwards symptoms of cerebral excitement ensued: the patient, bending 
his body would roll on his sides, and fall into lethargy, with occasional delirium. 
On the 8th nest, these signs remained the same, and he was removed to the hospital 
ship, Kobe-marn. When examined there, he was in a comatose condition, the face 
flushed and the pupils contracted a little, dull of reaction to the light, with incon- 
tinence of urine. Bandage was renewed and a mixture of bromide of potassium and 
sulphate of magnesium given internally. On the 9th inst., the bandage was changi <1. 
the stitchings were removed, as the wound began to suppurate. On the 13th, the 
discharge of pus from the wound became profuse, and by the probing of the wound 
from its upper corner, it went beneath the scalp 6 cm., the temperature was 38° C. ; 
brain symptoms were the same as those on the previous day ; a counter opening was 
made at the bottom of the wound and a drainage tube introduced. On the Kith, the 
brain symptoms seemed to havi somewhat subsided, the delirium and incontinence 
of urine nearly ceased. On the 20th, the patient was admitted to Sasebo Naval 
Hospital. At that time, the wound on the left forehead was wide open, exposing the 
bone stripped of its membrane, and discharging pus freely ; the brain symptoms still 
continued : the patient was almost unconscious with occasional delirium ; the pupils 
contracted. An ice bag was applied to the head and a saline purgative was gi 
On the 22nd, the senses became much restored and the discharge of pus decreased. 
On the 25th, an opening was made in tie- scalp over the region of the coronal suture 
where the pus accumulated, through the patient having to lie on his hack all the 
time. On the 28th, the granulation developed to such an extent that tin- exposed 
bone was at last covered ; pus discharge became less and less; the mind gradually 
enlivened, headache disappeared, but giddiness prevented him from standing up. 
March 5th : all the symptoms subsided ; iodide of potassium was given internally. 
April 7th, the wound contracted to a small granulating surface and the discharge of 
pus entirely ceased, experiencing no giddiness when he stood up, the patient began to 
try to walk. On the 14th, the formation of the skin over the wound was completed, 
ami a protecting bandage only was applied. From that time, the body daily increased 
in strength, so that he could walk with ease. On May 15th, he was removed to 
Yokosuka Naval Hospital where tonics and nutritious diets being employed, he fully 
recovered on June 1st and returned to his former service. 



74 INJURIES OF THE HEAD. 

53.— Compound fracture of the face and base of cranium ;— K. Kanai, 
aged 24. 1st c] an of the Hiyei, was, during tbe battle of the Yellow sea, 

staudiug in tbe surgery, where be, us a stretcber-bearer, bad carried an injured man, 
when a 30.5 cm. shell piercing through the starboard side exploded in the room. 
Some of its fragments, mutilated his face and the base of the cranium. He was 
killed on tbe spot. 

54. — Compound fracture of the face, base of cranium and both ex- 
tremities: — T. Oya, aged 23, a junior carpenter of the Hiyei. In the engagement 
of the Yellow sea, he was, as a member of the fire-brigade, standiug by No. 5 pump, 
in front of tbe paymaster's office in the fourth division of the lower deck, when a 
30.5 cm. shell exploded in the ward-room in the fifth division. Be was hit by - 
of the flying fragments, receiving a compound fracture, extending from the face to 
the cranial base and several other wounds on tbe upper and lower extremities. He 
died immediately. 

55. Penetrating wound of the cranium :— H. Ota, aged 26, a petty officer 
of the Itsukusbima. In the ttle, be was on tbe fore part of the upper deck, 

when a shell exploded through tbe netting in the fore part of the port side. On 
the broken pieces penetrated lus forehead and lodged in the brain killing him 
on tbe spot. 

56. — Y. Takahashi, aged 36, Lieutenant of'the Hasbidate. In the naval right 
of the Yellow sea, lie was commanding in the tower of tbe Si cm. gun in the fore 
part of the upper deck, when a shell from tbe starboard alter quarter hit against the 
inner wall of the gnu-shield and exploded just over bis bead. The fragments -truck 
his head causing several penetrating wounds of the skull. He died immediately. 

57. -K. Senokuchi, aged 29, Lieutenant ol the Bashidati During the naval 
battle of the Yellow sea. be stood in the tower of the 32 cm. gun in the fore part of 
the upper deck, and was about to give orders to aim at a hostile ship, when a shell 
struck against tbe inner wall of the shield and exploded jusl over his bead; pieces 
of the shell inflicted several penetrating wounds of the skull in the region of the 
forehead and tbe temple, which killed him on the spot. 

58 G Biroshige, aged 26, a gunner of the :',•> cm. bow-gun of the Hash. 
In the battle of the Yellow sea. he was handling the revoh ing wheel in the tower of 
82 cm. gun in the fore \ v upper deck, when a shell exploded against the 



INJURIES OF THE HEAP. (5 

inner wall of the shield of that gun, some of the shell fragments struck him on the 
head inflicting several penetrating wounds of the skull. He died on the spot. 

59. — T. Uchizaki, aged 26, Sub-Lieutenant of the Fuso was, in the battle of the 
Yellow sea, standing, in command of the port battery, under the booms of the upper 
waist-deck, when a shell pierced through the water way of the upper deck, and 
burst against the booms and iron pillar of the port side. By one of the fragments, 
he sustained a penetrating wound just midway between the right frontal eminence 
and the coronal suture. The lesion was an irregular lacerated wound 2 cm. long 
and about half as wide, with a round hole about 1 cm. in diameter in the frontal 
bone, no cerebral symptoms were present. The wound was directly cleansed 
and a corrosive gauze applied. On the 21st, the patient was sent to the Sasebo 
Naval Hospital. The surface of the wound was at the time covered with 
healthy granulation, but insomnia was present. On examining the wound, the 
whole thickness of the cranium was found to be perforated, but where the foreign 
body was lodged could not be ascertained. The temperature indicated 38.° 5 C, 
the hair around the wound was shaved off; antiseptic precautions being most 
carefully obserevd. The patient was kept perfectly quiet. On the 28th, he com- 
plained of giddiness, headache and a slight nausea with disturbed sleep during the 
night. The wound however presented no bad signs, the temperature having reached 
to normal from September 23rd, an ice-bag was applied to the head, calomel 
purgatives and occasional administrations of hypnotics were resorted to. On 
October 7th, the headache entirely disappeared and the spirits became enlivened, with 
increased appetite. On the 16th, there was occasional complaint of tinnitus aurium; 
the temperature normal, the pulse slow, counting 55 ; a mixture of bromide of 
potassium and iodide of potassium was administered internally. November 2nd, 
giddiness, tinnitus aurium aggravated with chills and fever ; the temperature showing 
38°. 3C. The wound had been discharging a slight pus for some days, so bandage 
was renewed daily and ice was continuously applied to the head ; cerebral symptoms, 
however, indicating compression of the brain became apparent. On the 7th next, 
trephining was performed under strict observance of antiseptic measures. In the 
frontal fossa an abscess was formed which discharged a thick yellow pus and 
yellowish serum, but the situation of the foreign body could not be ascertained. The 
pus cavity was washed out with a solution of boracic acid and a drainage tube intro- 
duced. The antiseptic dressing was changed everyday. After the operation the 
subjective symptoms were much relieved, the temperature stood at 37.°5 or 37.°6C; but 



76 INJURIES OF THE HEAD. 

on the 10th, it rose to 39°C. and the patient became unconscious : the eyes were fixed 
obliquely, the pupils unequal, the right small and the left large ; the pulse grew soft 
and feeble counting 148; respirations stertorous, with frequent hiccoughs, and num- 
bering 50 per minute. At 4.15 p.m. on the 11th, be died of coma. (See the illustra- 
tion appended.) 

60. — K. Kimura, aged 21, signalman of the Fuse, dming the battle of the 
Yellow sea, was Mowing a bugle signal, standing by the left side of the funnel 
casing, when a shell pierced through the lower part of the funnel, one of its pieces 
penetrating into the cranial base through the left side of the nape. The brain being 
thus smashed, he died instantaneously. 

61. — K. Nakagawa, aged 27, a conk of the Hiyei. At the battle of the Yellow- sea, 
he was lifting up shells at the entrance of the machine-gun magazine, below the 
ward-room of the lower deck, when a 30.5 cm. shell exploded in the room and broke 
tin' deck. One of the fragments of the shell, in falling, inflicted a penetrating wonnd 
mi las forehead, tie became semiconscious and complained of a burning sense in 
his hack. He finally expired from coma forty minutes alter the injury. 

02. — T. Matsunaga, aged 25, seaman of the Akagi. In the engagement of the 
Yellow sea, he was at work, as a pumper, turning the Downton pump in the fore part 
of the upper deck, when <me of the fragments of a hostile shell that flew in from the 
starboard side gave him a penetrating wound at the right temporal region : the 
fragment remaining in the brain, lie died on the spot. 

63. — S. Watanabe, aged 27, seaman of the Akagi, in the naval tight of the 
Yellow sea, was, as one of the fire-brigade, standing in the fore part of the lower 
deck, when a shell exploded on the same deck, and one of the fragments, inflicted 
a penetrating wound of the skull at the left parietal region. The fragment being 
lodged in the brain, death was instantaneous. 

64 — K. Kawamura aged II). a seaman of the Tenryu. On January 80th, 1805, 
while he was tiring from the captured fort of Luchotsai at Wei-hai-wei, a shell 

struck against the barrel of the gun and broke it in two. the shell exploding at the 
same moment. A fragment of the shell inflicted a penetrating wound of the left 
temporal region. The wound in the soft part was of an irregular form. 4.5 cm. in 
its longest diameter ; the cranium was broken into several pieces, some of which 
•>••' re pr< ssi il down into the cranial cavity and the brain thereby severed. Death was 
instantaneous. 




■ .rf^im , u 'i«jfc*'«i 









V 



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aS>« 



v5 



SUB-LIEUTENANT UCHISAKI.' FUSO" I.J. S. 
PENETRATING WOUND OF THE CRANIUM. 



ws^P 




J li'tJTERNil. SURFACE Of A PIECE OF THE FRONTAL 

4 BONE !EM( /EC : TP I 1ININI 

if <e INTERNAL SURFACE OF THE SAME. 

- 



INJURIES OF THE BEAD. 77 

65.— Penetrating wound of the cranium and mutilation of right 

thigh- — I. Sanada, aged 20, one of the crew of the No. 7 light Hotehkiss gun on the 
Matsushima, in the battle of the Yellow sea, was firing the gun on the starboard 
side at the middle of the flying deck, when a shell exploded against the mounting of 
the same gun. Some of the fragments of the shell inflicted a penetrating wound on 
the left side of his forehead, at the same time mutilating the upper portion of the 
right thigh. He was killed on the spot. 

66.— Penetrating wound of the cranium and mutilation of the ab- 
dominal wall. — if- Hamada, aged 27 senior carpenter of the Akagi, in the same 
battle, was standing as one of the fire-brigade on the fore part of the lower deck, 
when a shell exploded on the same deck. Its fragments gave him a penetrating 
wound of the skull in the right temporal region and mutilated the lower portion of 
the abdominal wall so that his bowels and bladder protruded. lie died on the spot. 

<J7.— Perforating wound of the cranium.— M. Kobania, aged 21, seaman 
of the Akagi, in the engagement of the Yellow sea, was, as a pumper, engaged in 
turning the Downton pump on the fore part of the upper deck, when a fragment of a 
shell came in from the starboard side and inflicted a perforated wound from the 
external occipital protuberance to the spot between eye-brows, which of course 
caused instant death. 

68.— Mutilation 01 the head.— S. Matsuo, aged 29, a magazine man of the 
Itsukushima, during the combat of the Yellow sea, was at work in the torpedo-room 
in the fore part when a shell burst against the boom provided for the use of the 
torpedo-net on the outer side of the ship, and crushed the side opposite to the 
torpedo-room. One of the fragments of the shell severed the front part of his skull 
so as to cause instant death. 

69. — S. Arimatsu, aged 24, a magazine man of the Hiyei. In the battle of the 
Yellow sea, he was busy lifting up shells at the entrance of the machine-gun 
magazine below the ward-room. A 30.5 cm. shell exploded in the ward-room on 
the lower deck, and by one of the fragments that came through the deck, he had his 
skull mutilated so completely that the brain was smashed. Death was instan- 
taneous. 

70. — K. Chikamatsu, aged 21, a magazine man of the Hiyei, during the fight iu 
the Yellow sea, was lifting up shells at the entrance of the musket-shot magazine 
below the ward-room when a 30.5 cm. shell exploded in the ward-room on the 



78 INJURIES OF THE HEAD. 

lower deck. Some of the pieces struck his bead and scattered the bruin substance, so 
that death was instantaneous. 

71. — H. Nishihara, aged 21, one of the crew of No. 9 gun of the Hivei, iu the 
fight of the Yellow sea. While firing the gun, a shell passed through the starboard 
sea-port on the stern ; and during its passage to the stern port, he was struck by the 
shell and had all his skull mutilated except the base, so that the cranium as well as 
the brain were blown off. He died immediately. 

72. — S. Nakamuta, aged '24, one of the crew of No. 5 side-gun of the Akitsushima, 
in the engagement of the Yellow sea, was carrying shells in the neighbourhood of 
the starboard No. 5 side-gun on the waist-deck, when a shell exploded against the 
shield of that gun, and one of the fragments, smashed his cranium so that the brain 
was scattered. He died immediately. 

73. — Y. Karikawa, aged 22, one of the crew of No. 5 .side-gun of the Akitsu- 
shima, in the battle of the Yellow sea, was gathering empty cartridges on the fort of 
the starboard No. 5 side-gun of the waist-deck (in a bent posture), when a shell 
exploded against the shield of that gun. One of the fragments completely destroyed 

his skull. 

74. — II. Sakamoto, aged 40, Commander of the Akagi, in the battle of the 
Yellow sea, was inspecting the chart on the chartstand of the bridge, when a shell 
came through the stern and burst against the stand of No. 1 Q. F.-gun on the star- 
board side of the bridge. He was struck by one of the broken pieces, on the posterior 
part of the parietal region, so that whilst the face and cranial base were spared, the 
whole vault of the skull was destroyed and his brain completely dashed out and 
scattered. Death was instantaneous. 

75. — K. Nagatomi, aged 28, a cook of the Akagi, in the battle of the Yellow sea, 
was busy turning the Downton pump, in the fore part of the upper deck, when 
a fragment of a shell came through the starboard side, destroying the upper half of 
his cranium, leaving the lower half of the occipital bone. 

76. — K. Yasuoka, aged 85, senior blacksmith of the Akagi, in the engagement of 
tin.' Yellow sea, was, as one of tin' lire brigade, standing in the fore part of the lower 
deck, when a shell burst there. One of the broken pieces struck his head, and almosl 
entirely destroyed it, leaving only a part of the occipital bone and lower jaw. lb' 
died immediately. 

77. — K. Sbimada, aged 21, one of the crew of the small-calibred machine gun 



INJURIES OF THE FACE. 79 

of tlie Tenryu, at the time of the bombardment of the eastern fort of Liukung island, 
was standing at the gangway in tlie starboard-waist of the upper deck, when a 
shell burst striking a part of No. 2 side-gun on the .port. One of the fragments 
smashed the whole of his skull blowing away the brain. 

78.— Mutilation of the head with Compound fracture of Cervical 
vertebrae. — M. Sakata, aged 24, one of the crew of the No. 2 long 7.5 c.rn. gun of 
the Fuso, in the battle of the Yellow sea, was at rest cross-legged near the left side 
of the funnel-casing when a shell pierced through the lower part "i'the funnel, and 
some of the broken iron pieces crushed the occipital, the temporal, and the parietal 
bones, with the whole encephalon and the portion from the vertex to the left 
clavicular region as well as the upper half of the cervical vertebra 3 . He died on 
(lie spot. 

79. — Lacerated wound of the head and right upper extremity with 
compound fracture of the left lower limb.— I- Kawamura, aged 27, one of the 

crew of the revolving gun in the fore part of the Katsnragi, during the attack on the 
eastern fortress of Liukung island on February 11th, 1895, was working the gun. when 
a shell burst against the barrel. Some of the pieces crushed the upper part of his 
head leaving only a part of the lower jaw and occipital bone. The right shoulder 
joint was also so severely torn that it hung by a mere strip of muscle and skin ; the 
left knee joint was torn open, so that the patella protruded ; and a compound fracture 
of the left femur was sustained. He was killed instantaneously. 

80.— Severance of the cranium with lacerated wounds in both feet. 
— S. Mizushima, aged 28, a seaman of the Amagi, on January 80th 1895, was 
firing on tlie enemy's vessels in the harbour, from the occupied fort of Luchotsai at 
Wei-hai-wei, when a shell from the enemy struck the barrel of the gun and broke it in 
two. One of the fragments crushed his skull, and completely dashed out his brain, 
both feet being mutilated at tlie same time. He died in a moment. 



3 INJURIES OF THE FACE. 

(A) INJURIES TO THE SOFT TARTS. 

81. — Excoriation of the face. — K. Yamaguchi, aged 40, boatswain of the 
Hashidate in the engagement of the Yellow sea, was standing by the left side of 



SO INJURIES OF THE FACE. 

the towei' of the 32 cm. gun ou the fore part of the ripper deck, in charge of the 
tackle-menders and stretcher-bearers, when a shell exploded in the tower. One of 
the flying pieces grated off the varnished paintings on the tower-wall and hit against 
the lower edge of his lower jaw and inflicted an excoriation. Adhesive plaster was 
applied ; and the lesion healed the next day. 

82. — -A. Mikogami, aged 41, senior medical attendant of the Hashidate. In the 
fight of the Yellow sea/lie was directing the carriers of the wounded by the left side of 
the tower of the 32 cm. gun in the fore part of the upper deck, when a shell 
exploded in the tower. One of the pieces blown off the varnished paintings on the 
tower-wall hit his right malar region and inflicted an excoriation. It was covered 
with a piece of adhesive plaster and healed the next day. 

83. —Excoriation of the face with burns in the lumbar region :— 

T. Ishii, aged 23, a man of the bow-gun of the Hashidate, at the battle of the Yellow 
sea, was in the tower of the bow-gun and was handing the gas-plate, which was just 
pulled out, to No. 6 man of the gun, when a shell from the enemy exploded in the 
tower; one of the flying pieces knocked off the varnished paintings on the tower- 
wall hit the tip of his nose, inflicting an excoriation, while at the same time, the 
explosion flame of the shell gave him a slight burn in the loins. Adhesive plaster was 
applied to the excoriation and olive oil to the burns. 

84 — Abrasion of the face : -K. Kawara, aged 34, a petty officer of the Furo, 

who in the engagement of the Yellow sea, served as a tackle-mender as well as 
messenger, was at rest cross-legged under the port side of the fore bridge, when a shell 
came through the lower part of the funnel ; and one of the broken pieces inflicted a 
linear abrasion on the left cheek. A corrosive sublimate gauze was applied, and it 
healed on the 10th day by scabbing. 

85. — T. Muroi, aged 24, a man belonging title- stern-gun of the Akitsushima, 

at the time of the attack against the forts of Liukung island on Februarj 7th. Is''.". 
came to the side of the stern-gun on the poop-deck, earning the cartridges, when a 
fhell burst mi the deck, one of whose fragments hit his left cheek inflicting a super- 
ficial abrasion 1 cm. long. A corrosive gauze was applied, and on tie- 11th of the 
same month, the lesion h ale 1 by drying. 

86. K. Miyake, age I SO, a petty officer of the Tenryu, ou January 80th, 1895, 
was partaking in th9 bombardment of the enemy's ships in the port of Wei-hai-wei 



rSJUEIES OF THE PA.CE. 81 

from the occupied fort of Luchotsai, \\he:i a shell fired from the ship Teug Yueu 
struck the barrel of the gun in the fort aud explodad, breaking the gun in two. 
One of the shell fragments inflicted an abrasion about 1 cm. bug on the part im- 
mediately abave the right superciliary ridge. It was closed with adhesive plaster 
and healed on the 6th of the next month by scabbing. 

ST.— Abrasion of the face and right shoulder :— Y. Hondo, aged 22, a 
seaman of the Matsushima, at the engagement in the Yellow sea, was engaged in the 
conveyance of shells in the fore part of the upper desk, when a 30.5 cm. shell burst 
in the fore part of the lower deck, breaking some of the ship's timbers and implements. 
Some of the iron-fragments that were thrown on to the upper deck infli:-ted abrasions, 
one on the left cheek and another on the right scapular region. Iodoform was sprin- 
kled over them and they were then covered with adh jsive plaster. The lesions healed 
by scabbing on the 13th day. 

88.— Abrasion of the left Uppsi eyelid :— S. Yamaguchi, aged -24, a seaman 
of the Matsushima, in the fight in the Yellow sea on Sept. 17th, 1894, was standing on 
thi fort of the starboard chasing gun in the fore part of the upper deck, when a 30.5 
cm. shell burst in the forepart of the lower deck breaking the ship's timbers and 
implements. The iron fragments flew to the upper deck, and one of them inflicted 
an abrasion on the left upper eye-lid. The wound was sprinkled with iodoform and 
covered with adhesive plaster. It healed on October 3r.l by scabbing. 

89. — Abrasion of the right ear: — N. Yamamoto, aged 19, a seaman of the 
Hiyei, in the naval engagement in the Yellow sea, was on the relieving tackle station 
in the lower deck stern cabin, when a large shell of the enemy's exploded in the next 
ward-room shattering the walls and deck. One of the flying pieces of wood, in- 
flicted an abrasion 2.5 cm. long in the right ear. The lesion was sprinkled with 
iodoform and covered with adhesive plaster. It healed on the 5th day by scabbing. 

90. — Contused wound of the face : — A. Kosa, aged 20, one of the torpedo-crew 
in the fore part of the Matsushima, in the naval battle of the Yellow sea, was at his 
station in the fore torpedo-room, when a 30.5 cm. shell burst in the fore part of the 
lower deck. One of the fragments, that flew into the room, struck him and inflicted 
a slight contused wound, extending from the lower margin of the nasal septum to 
the median raphe of the upper lip. The wound was sprinkled with iodoform and 
closed with adhesive plaster. It healed on the 13th day. 



82 INJURIES OF THE FACE. 

91. — M. Sakaiya, aged 21, a man belonging to No. 2 Hotchkiss gun of the Fuso, 
in the attack of Zhih island on February 7th, 1895, was standing near the bellows on 
the upper deck, when a shell perforated the gallant-forecastle and burst. One of the 
fragments inflicted a small contused wound below the left orbit. When examined, 
the soft tissues around were so swollen that the eye-lids closed and could not be 
separated, but happily without causing any injury to the eye-ball. The lesion was 
therefore washed with a carbolic lotion and sprinkled with iodoform, then compressed 
with tight-bandages. The swelling subsided gradually and the wound healed on 
February '20th by scabbing. 

92. — K. Yanagimoto, aged 17, a seaman of tin; Biyei, in the naval battle of the 
Yellow sea on September 17th, 1891, was handling the rudder by the wheel on the 
quarter-deck, when an enormous shell exploded in the ward-room on the rear of the 
lower deck. He was thrown down by the shock of the explosion, knocking his head 
against the bridge and thus sustained a contused wound in the front part of the right 
ear. All the surgeons on board the ship were killed at once by the same disastrous shell, 
and he had to be only temporarily dressed with a bandage until next morning when 
the ship arrived at tin station of the squadrons near Cape Choppeki. He was treati d 
by one of the surgeons from another vessel. Conditions of the wound : at the lower 
margin of the right temporal region — that is, just in front of the right ear, there 
was a wound 1.5 cm. long and 1.2 cm. wide, vanning obliquely backwards and 
downwards; the margin of the wound was irregular and the bottom uneven, but no 
injury was caused to the temporal artery. Carbolic gauze was applied ; ami after 4 
days the lacerated margin of the wound sloughed. The surface then presented 
development of granulation. Carbolic gauze was again applied ; the wound progressed 
favourably, and healed by granulation on October 9th. 

!':! V. Kamiya, aged 21. one of the crew for the No. 9 stern gun of the Uiyei, 
in the naval engagement of the Yellow sea, was engaged in firing by the right side 
of the gun ; when a shell from the enemy broke through the aft and upper part of the 
starboard stern gun port. One of the wooden splinters inflicted a contused wound, 
at the right corner (if his month, 1.5 cm. long and <; m.m. wide, reaching the sub- 
mucous tissue, [t was sprinkled with iodoform, and the margin of the wound was 
closed by adhesive plaster. It healed on the 1 1 i i day by primary union. 

94 J. Kimiya, aged 25, a stoker of the Tenryn, in the bombardment of the eastern 
fort of [iin-kung island, on February 11th, 1895, was as one of the fire-brigade, stan- 



INJURIES OF THE FACE. 83 

ding iu the starboard waist of the lower deck, when a shell struck the No. 2 port gun 
and burst, badly damaging the upper deck and the skylight of the engine-room. The 
broken fragments of iron and wood showered on to the lower deck, and one of wooden 
splinters hit his right cheek, inflicting a contused wound 4.5 cm. long. The sub- 
cutaneous tissues were pierced, and part of the masseter lacerated ; the margins were 
irregular, and the wound open about 1.5 cm. It was cleansed with a carbolic lotion ; 
the margins pared off and sutured. Corrosive gauze was applied, but on the 15th, 
as the wound suppurated, the threads were removed, and the dressing was renewed 
every day. From the 22nd, the discharge of pus decreased day by day ; the granula- 
tion went on favourably and the wound contracted by degrees. On March 3rd, it 
healed by the complete formation of a cicatrix. 

95. — T. Kashiwabara, aged 21, an oil-man of the Saikyo-maru, in the engagement 
of the Yellow sea, was standing near the entrance of the engine-room, when two 30.5 
cm. shells from the enemy rebounded at the same time from the sea on the starboard, 
knocked through the ward-room on the upper deck, and exploded just in front of the 
port side of the ward-room. One of the wooden splinters, inflicted a contused wound 
on his face. It was superficial, and 3 cm. long, running transversely across the right 
malar region. The margins were clean with a little bleeding. They were sutured 
and sprinkled with iodoform, and the wound covered with adhesive plaster. The 
wound healed by first intention on the titli day. 

96.— Contused wound of the face with contusion of the right knee 
joint : — H. Dan, aged 23, a petty officer of the Fuso, at the attack on Zhih island 
of the 7th February, 1895, was stationed as a signal-man of the ship's speed, and was 
standing by the starboard side of the fore-mast on the upper deck, when a shell pierced 
through the gallant-forecastle and burst. Some of the small fragments of the shell 
inflicted a small contused wound on the right cheek, and a contusion on the outer 
side of the right knee joint, the latter of which became somewhat swollen and attended 
with pain. The wound on the face was closed with adhesive plaster, and that on the 
knee tightly bandaged. Both lesions healed on the 15th of the same month. 

9". — Contused wound of the face with abrasion of the left forearm 

and tha right thigh : — G. Yamashila, aged 27, one of the crew of the fore revolving 
gun of the Katsuragi, in the bombardment of the eastern fort of Liukung island on 
February 11th, 1895, had scarcely turned the gun so that he could fix it, when a 



SI INJURIES OP THE FACE* 

hostile shell struck the barrel and burst into nieces. One of the shell fragments gave 
him a contused wound 1.5 cm. long on the chin ; it reached beneath the skin causing 
slight bleeding, but no injury to the bone. At the same moment, au abrasion of the 
outer side of the right thigh was inflicted by a wooden splinter ; and the front of his 
left wrist was bruised so as to interfere with the movements of that joint. The 
wounds on the chin and thigh, were covered with sublimate gauze ; and the wrist was 
fixed up. Next day, the patient was removed to the hospital ship Kobe-maru and 
whilst being treated in that vessel, both wounds nearly healed by cicatrices, the swel- 
ling and pain of the left wrist also subsided greatly. He was then removed to the 
Sasebo Naval Hospital. On admission, the wound on the lower jaw was covered with 
a bloody scab ; the abrasion of the thigh was completely healed, and the swelling on 
the wrist had nearly subsided, leaving only a patch of ecchymosis which was 
undergoing absorption. On the 26th of the same month, he left the hospital to resume 
service. 

t>y.— Contused wound of the face, neck and extremities:— T. Yarnanouchi, 

aged 30, a cook on board the Tsukushi, in the attack on /jliih island on February 3rd, 
18!)5,was working in the kitchen on the lower deck, when an enemy's shell broke 
through the upper deck, passed down to the lower, and there pierced the kitchen. Some 
of iron and wooden pieces thus broken off struck him, inflicting several contused wounds : 
one 3 cm. long and 1 cm. wide on the upper lip close to the right nasal wing ; one 111 
cm. in length and 1 cm. in width, extending from the lower part of the right ear to the 
neck ; also small wounds were found on the right eye-brow, over the right cheek, un 
tln> left index linger, nn the outer side of the right thigh, on the back of the right 
elbow ; besides, there were numerous fine pieces of splinters sticking in the exposed 
parts such as the face, neck and hands. The wounds were cleansed with a carbolic 
lotion and sublimate gauze was applied .; they progressed favourably without suppura- 
tion, and healed on the 15th of the same month. 

99.- Contused wound of the face and limbs with contusion of the left 
thigh : — K. Tabata, aged 25, one of the crew of the starboard '.» pounders of the 

Tsukushi, in the attack on Zhih island on Fi bruary 3rd, 1895, was standing by his 
gun on the middle part of the upper deck', when a shell came from the port side and 
pierced through the lower part of the funnel. Home of the iron pieces thus broken 
off inflicted several contused wounds, as following: —one :! cm. long on the back of 
the left wrist, one on the back of the left hand, one 5 nun long on the back of the right 



INJURIES OF THE FACE. yg 

band, one 1 cm. squire on the left eye-brow, and one on the upper lip ; one 1 cm. 
long and as deep as the periosteum, at a spot 5 cm. below the left patella ; one over 
the dorsum of the left foot, one on the dorsum of the right great toe. Besides, there 
was a contusion 1 cm. square above and inside the left knee, which gave pain in 
walking. Those wounds wne washed with a carbolic lotion and foreign substances 
were extracted. Sublimate ganze was then applied, and the inflamed parts kept cool. 
On the 5th of the sania month, he was removed to the transport Yedo-maru and 
admitted to Sasebo Naval Hospital on the 10th. On admission the bandages were 
for the first time changed, when the wound on the left wrist was developing granula- 
tion, the other .smaller ones had completely formed scabs. The same treatments 
were continued, and the case progressed favourably. On March 14th, he left the 
hospital to resume his service. 

100.— Contused wound of the left ear: — Y. Kamada, aged 32, one of the 
crew of the stern-gun of the Akagi, in the battle of the Yellow sea. was engaged in 
tiring upon the enemy, and was standing on the fort of the stern-gun in the rear of the 
upper deck, when a shell exploded piercing the shield of the gun. He sustained, from 
one of the fragments of the shell, a lacerated wound 1.5 cm. long, above and in front 
of the auricle. A flap hung from th ■ lacerated part and the wound bled profusely. 
The haemorrhage was stopped by twisting the vessels; and the flap united by 
adhesive plaster and corrosive gauze applied. When the bandage was removed on 
the 7th day, the flap had healed by the first union. He had on the 4th day completely 
recovered. 

101.— Contused wound of the left ear and back of hand:— R- Kimura, 

aged 23, a servant to the Captain of the Saikyo-maru, in the battle of the Yellow sea, 
went on to the bridge carrying a message for the Captain. He finished his business, and 
on his way back was just passing the entrance of the ward-room, when suddenly two 
30.5 cm. shells from the enemy rebounded from the sea on the starboard side, knocking 
through the ward-room on the upper deck and exploding on the port side of the ward- 
room. The fragments of the shell and wood were driven about, and some of them 
struck him on his left ear and hand. On examination, there were two contused 
wounds: one, H shaped, 3 cm. in length at the middle of the back of the hit 
pinna ; and the other 6 m.m. on the back of the left hand. Both lesions were super- 
ficial, so that the bleeding was slight. loloform gauze was applied ; and after a week 
the lacerated margins on the hand sloughed while that of the eir was slightly inflamed 



86 [JfJUUIES OF THE FACE. 

causing suppuration. The wounds were treated with carbolic lotion and sublimate 
gauze. The sloughs having come oil' on the 14th day a granulation set in favourably 
and the lesion lessened remarkably. On October 10th, both w. muds were completely 
In nl.'d by cicatrization. 

(B) WOUNDS OF THE V\CE WITH FKACTURE. 

l' '2 —Compound fracture of nasal bone with abrasion of the right side 
of the chest : — Y- Nagamine, aged 33. a petty officer of the Matsusliima in charge of 
the after magazine. In the battle of the Yellow sea, he was passing the waist of the 
lower deck, to inspect the supply of shells, when a 30. o cm. shell exploded in the fore 
part of the lower deck, and one of its fragments inflicted a contused wound on the dorsum 
of his nose, witii fracture of the right side of the nasal bone. Another fragment made 
a small abrasion over the region of the 10th rib, in front of the right side of the chest. 
Iodoform was sprinkled on the wounds and sublimate ganze applied, and fixed with 
adhesive plaster. On September 20th, the abrasion of the chest had healed up, while 
there was a little discharge from the wound of the nose, attended with a slight swelling 
around its margin. The wound was washed with carbolic lotion and covered with iodo- 
form gauze, which was changed every other day. On the 30th, the discharge had 
nearly ceased and the surface of the wound was greatly reduced by the development 
of granulation. Treatment continued as before, the bandage being renewed twice a 
week. I'n October 15th, the wound on the dorsum of the nose was nearly healed 
leaving only a surface of granulation, the size of a beau to which boracic ointment 
was applied. On the 26th a cicatrix finned so fairly, that the wound healed without 
leaving any striking deformity. 

n '3.— Compound fracture of superior maxillary bone I accompanied by 
retinal haemorrhage i with penetrating wound of left arm and contused 
wound of left forearm: — T. Hanamitsu, aged 21, a man of No. 4 q.f. gun of the 
Akagi. In the battle of the Yellow sea, he was temporarily ordered to turn the pump 
and was hurrying to the fore part of the upper deck, when fragments of a hostile 
up from the under part of the shield of No. 3 gun. and inflicted, several 
wounds on his face and left upper extremity. On examination the wounds were found 
to be as follows : — first, a wound 1 cm. in diameter just below the left eye, passing into 
the antrum of Highmore Bli eding was profuse, bnl the posterior wall of the antrum 



INJURIES OF THE FACE. 87 

was intact and his mind clear without any cerebral symptoms. Secondly, a perforat- 
ing wound on the outer side of tbe upper part of the left arm. The entrance orifice was 
found in the front of the arm measuring 5 cm. in diameter, with loss of the soft tissues 
and laceration of the margins. The deltoid muscle was pierced making an exit on 
the outer and posterior side of the arm. The exit was ragged and the crushed mus- 
cular fibres were seen protruding. Its size was rather smaller than that of the inlet. 
There was bleeding from the wound but the shoulder joii i lesion. Thirdly, 

two lacerated wounds, each 2 cm. long, were found : one just beneath, the elbow joint 
on the outer side of the left fore arm, and one on the inner side the of same joint. 
The wound of the face was cut open a little, and on examining the inside some frag- 
ments of the broken bone and blood cl I, but there were no for. 
bodies to be found. After the application of an antiseptic dressing to the wound, the 
patient was kept in absolute rest. On the 18th, bleeding occurred from the wound, 
the lids of the left eye were swollen and discoloured the temperature rose to 39° C. ; 
the dressing was renewed. On examining the eye two or three small, black iron 
fragments were found sticking in the conjunctiva, these were extracted, and the eye was 
cleansed with boracic lotion and the compress applied. On the morning of the 19th, 
the temperature fell to 37. "5 C: he was taken on board a transport bound for home 
and was admitted to the Sasebo Naval Hospital on the 21st. On admission, the left 
half of the face was swollen, — especially the left eye lids — accompanied by pain : tbe 
conjunctiva was also inflamed. On examination, the conjunctiva was found still to 
retain a black speck which was soon cleansed away and the application of boracic 
compress continued. The other wounds were doing well, the temperature not exceed- 
ing normal. On the 26th, the surfaces of the wounds began to show the develop- 
ment of granulation : on the 30th, he was removed to the Knre Naval Hospital. At 
the time, the swelling of the left eye-lid, and conjunctivitis, was gradually snbsidiug. 
The vesion when examined was found to be T 2 ff ° 5 . As for the wound of the face, the 
granulation developed so as to fill up the antrum of Highmore but a discharge of pus, 
mixed with blood, came out of the nose and mouth, so the nasal passage was washed 
with carbolic lotion. At this time, anaesthesia of the lips and left cheek was com- 
plained of. On October 10th, the wounds of the fore-arm were almost healed, and 
that of the arm likewise presented favourable granulation. Pain was complained of 
at the outer side of the left elbow, and on close investigation a fracture of the outer 
condyle of the humerus was discovered. This was fixed by a bandage. On the 23rd, 



88 INJURIES OF THE FACE. 

the inflammation of the left e\ e was entirely subdued yet there was uo sign of recovery 
of the eye sight. On examining the fundus a h emorrhage of the retina was recogniz- 
ed. After the 23rd, internal administration of iodide of potassium and iujection of 
pilocarpine were tried. On November 13th. the canal of tbe perforated wound of the 
eft arm -was closed at its middle part, the openings at both ends being also rilled with 
Igranulation ; the surface of the facial lesion grew even, and the discharge from the 
nose and mouth entirely ceased. On December 18th, the facial wound healed, a 
cicatrix the size of a li> sen coin being formed. On January 2nd, 1895 the wound of 
the arm, as well as the fracture of its external condyloid eminence, had healed; the 
left arm however was emaciated, with much loss of grasping power, and on movement 
of the elbow joint, pain was felt along the ulnar nerve. The anaesthesia of the left 
cheek and lips still continued as before. The sight of tbe left eye was less than -^p^ 
and he could hardly count fingers at a distance of 4 feet. Thus Vicing unfit for active 
service : he was p irmaneutly invalided on February 9th and granted a pension accord- 
ing to regulation. 

104. --Compound fracture of the lower jaw :— S. Koyama, aged 26, one of 
the crew of the 17 cm. gun on the port side of the Fuse. In the battle of the Yellow 
sea, he was at rest, sitting cro legged, on the port si 1 • of the funnel easing, when a 
shell burst through the lower part of the funnel, scattering the fragments, and one of 
them inflicted a compound fracture of the right side of the lower jaw. Tbe wound 
was dressed temporarily and he was admitted to Sasebo Naval Hospital on September 
21st. On admission, the condition of the wound was as follows : — it was a lacerated 
wound 4 cm. long and 2 cm. wide, extending from tbe right angle along tbe in- 
ferior border of the lower jaw. Tbe margins <>f the wound were remarkably sevi 
presenting a ragged appearance and being wide open. The horizontal portion of tbe 
maxilla was crushed to piece-, and was retained in Sitii by means of tbe periosteum 
and muscle. The broken pieces were removed and tin' wound was closed with iodo- 
form gauze. On the 27th, two m ire pieces became loose and were extracted, one being 
the size of the tip of the thumb and the other that of the index linger. Tbe move- 
ments ol the jaw were not interfered with, and the wound progressed favourably and 
healed by the formation of a cicatrix on October "27th. 

105. — Bullet wound of the lower jaw : S. Kawada, aged 27, a seaman of 
the Naniwa. On March 24th, 1895, while reconnoitring a native bouse in tbe Pesca- 
dores, on duty with a landing party, b was, suddenly shot b\ a rifle at a distance of 



INJURIES OP THE FACE. 89 

a few yards whore an enemy lay in ambush, and sustained a wound extending from 
the lower jaw to the neck on the right side. He was immediately attended by a 
surgeou belonging to the landing party, and soon returned to the ship. On examina- 
tion, the wound was found to extend from the chin along the lower border of the 
horizontal ramus of the lower jaw, to the lower and outer part of the neck. It mea- 
sured 12 cm. in length and a gap of about 8 cm. in its widest part. It penetrated into 
the cavity of the month, and in its passage severed the mylo-liyoid, geuio-byoid and 
subrnaxilliary gland completely, and the genio-hyo-glossns partly. The right side of 
the body of the lower jaw was broken into several pieces, a part of it being pulverized. 
By the laceration of the muscles the tongue was drawn back causing difficulty in 
speaking and swallowing. The carotid artery, though its sheath was exposed, happily 
escaped injury. The lingual artery was likewise uninjured. The facial artery was 
severed but bleeding soon stopped : there was only capillary haemorrhage accompanied 
by a little pain. The bullet seems to have entered through the chin and found its 
exit in the right side of the neck, crushing the jaw and the skin over it in its course. 
There was another small lacerated aperture about 2 cm. in length somewhat behind the 
right side of the neck, through wbicb b >uy fragments seem to have passed out. The 
loose fragments of bone were extracted, the surgeons at the same time endeavouring to 
preserve the periosteum and gums as much as possible. The lacerated mucous mem- 
brane of the mouth, was pared and the margins sutured. A gargle of boraeic 
acid was ordered. The lacerated portions of the skin were sutured too, as far as union 
eonld he expected, and a carbolic gauze was applied : a fluid diet being ordered. On 
the 2Gth of the same month, except the union of a small portion of the skin the great- 
er part had become gangreuous. The sutures were therefore removed, iodoform was 
dusted on and a wet carbolic dressing applied : the temperature kept at about 3S° C, 
but rose to 39° C. on the evening of the 2Sth. A moderate dose of quinine was ad- 
ministered night and morning, and the dressing was reuewed twice a day. On the 
29th, the sutures of the mucous membrane of the month came off, leaving a gap to 
which absorbent cotton wool was applied. The discharge of pus from the wound 
was copious, and its lacerated portion having sloughed, an offensive odour was emitted. 
On the 31st. the sloughs gradually came off, and granulation developed at the bottom 
of the wound. Since the preceding night, the temperature had not exceeded 37.°8 C. 
This day the patient was removed to the hospital ship Kobe-maru. Examined on 
board the vessel : the greater part of the right half of the body of the lower jaw. from 



90 INJURIES OF THE PACE. 

its angle to the symphysis, was damaged ; tlie bicuspids, the first molar and a part of 
the second molar were lost, whilst the incisor teeth were loosened. The soft parts 
around the chin and the upper part of the neck were torn open, the pulsation of the 
carotid artery could he seen at the hottom of the wound which communicated with 
the cavity of the mouth, through a laceration about 1.5 cm. wide : granulation was 
unfavourable and the pus discharge copious. On April 1st, the temperature rose to 
'■'•'< 3 C. and the mucous membrane under the tongue became swollen, pain being 
complained of at the part. The dressing was changed twice daily as before, and a 
gargle of chlorate of potash was administered. On the next day the temperature fell 
to the normal point, and the slough of the wound having completely come off, granu- 
lation became even and the pus discharge almost ceased. On the 4th, he was trans- 

l on board the Bankoku-maru homeward-bound, and was admitted to Sasebo 
Naval Hospital on the 8th. From that time, the temperature kept normal the swelling 
of the mucous membrane of the mouth subsided, the pus discharge became very slight 
and granulation developed gradually. On the 20th, a small fragment of bone which 
appeared on the surface of the wound was extracted. In May, the greater part of the 
wound had formed a cicatrix, but the laceration communicating with the mouth had 
not yet closed. The lacerated part was touched with silver nitrate. On the 16th, the 
patient was removed to Yokosuka Naval Hospital. At the time, the greater part of 
the wound had formed a curved cicatrix, 12 cm. long, running along the inferior 
margin of the right side of the lower jaw, in the middle of which a granulating 
surface of 2 cm. long was left, communicating with the cavity of mouth by a small 
sinus. As the right half of the lower jaw had been damaged the chin inclined to the 
right, so that the juxtaposition of the upper and lower teeth was lost when the mouth 
was shut : consequently articulation, mastication and deglutition were greatly hind- 
Tin- treatment was the same as before and the fluid diet continued. On I 
the loose canine and incisor teetb were pulled out. On June 3rd, two | dead 

I '..ere picked out of the wound in the mouth. On July 26th, the sinus communi- 

- with the moutb at last closed, and the surface of the wound contracted greatly. 
On A 7th, tin- wound healed completely by the formation el' a cicatrix hut the 

twisting <jf the lower jaw became still greater. Bj the continuous use of tonics and 
nutrition- strength of his body was gradually restored. However, from the 

loss ef a part of the lower jaw articulation and mastication were seriously ii:;: 
he was invalided fa- life on January 15th, 1896, anil granted a pension according I i 
regulations. 



IXJUIIIES OF THE FACE. 01 

10!).— Compound fracture of the face (rupture of the right retina) with 
a blind wound of the right leg :— S. Ikebe, aged SO, a seaman of the Akitsnsbima. 

In the battle of Yellow sea on September 17tli, 1891, be was acting as tackle-mender, 
also assisting in carrying shells to No. 5 side gun, when an enemy's shell exploded by 
striking against the shield of that gun. Some of the flying fragments inflicted a 
compound fracture on the dorsum of the nose and a blind wound on the inner side of 
the lower part of the right leg. 

On examination, a vertical lacerated wound was found extending from the 
summit to the middle of the dorsum of the nose. The nasal spines of the frontal 
bono, the nasal bones, the nasal processes of the superior maxilla and a part of the 
perpendicular plate of the ethmoid were crushed, and the wound presented a cave- 
like appearance, retaining in it pieces of bone and fragments of the shell. There was 
an ecchymosis into the right orbit of the eye ; and a marked swelling of the right 
lid, so that the eye could not be opened. There were also penetrating wounds, one 
at the lower part of the inferior margin of the right orbit, and the other at the upper 
and outer part of the right corner of the mouth. In the latter wound a fragment of 
shell about the size of the tip of the thumb was disc ivered. Another small wound was 
found on the inner side of the lower part of the right leg. Also burns, due to the explo- 
sion of the powder, were present on several parts of the face. The fragments of shell 
and bone were extracted from the wound in the nasal region and a fragment of shell from 
the wound near the corner of the mouth. All the wounds were dressed antiseptically. 
During the night bleeding occurred from the wound at the nasal region so as to wet 
through the bandage which was therefore changed, and a cold compress was applied 
over it. Next morning, the heemorrhage had stopped entirely, but the swelling of the 
face was severe, especially over the eye-lids. On the 19th he was sent to Sasebo 
Naval Hospital on a transport and admitted on the 21st. At the time, the face, 
especially the right half, was remarkably swollen ; the right eye-lids were so swollen 

that the examination of the eye-ball could not he made. The left eye-lids were 
slightly swollen too, with congestion of the conjunctiva, but the sight was not obscured. 
In the wound below the right orbit a hard lump was found which was cut open, and 
proved to be, a small fragment of shell and was extracted. On the 28th, the swelling 
of the face had subsided. On the 5th of October, the wound of the nose had developed 
granulation mi ;i^ to cover the fractured parts. Along the septum and left side of the 
nose, there was a tenderness, accompanied by anaesthesia in the right half of the 



92 INJURIES OP THE FACE. 

forehead and cheek. The right lower wisdom tooth was extracted as it was loose 
and gave pain, owing to its partial destruction hy a fragment of shell that had entered 
through the right cheek. Of the eye, the right pupil was dilated and the sight 
remarkably impaired so that he could only distinguish light from dark. By an ophthal- 
moscopic examination, rupture of the retina was discovered. On the 14th the wound 
above the inner ankle of the right leg, was narrowing in its inlet yet pus accumulated 
inside, so it was cut open to evacuate the pus. By probing through the open wound 
a small fragment of shell was found on the inner side of tendo Achillis. which 
was extracted, a counter opening was made behind the outer ankle, and a drainage 
tube introduced. On the 21st, the wound on the right cheek had healed ; and on the 
25th of November, the wound on the leg had greatly narrowed by the development of 
granulation, so the drainage tube was removed ; the lesion of the nose also became 
gradually narrowed. On December 23rd, the wound of the right leg was healed. The 
right eye gradually recovered its sight so that the patient could now perceive objects 
clearly, but the pupil remained as much dilated as ever, and external strabismus 
resulted, so that the patient complained of diplopia. On the 24th of February, 1*'.'">. a 
plastic operation was performed. The procedure was as follows :— Under chloroform the 
skin over the superior maxilla was fully separated round the nasal wound and brought 
together at the median line by stitches ; drainage tubes were inserted into the nostrils 
and dressed antiseptically. On March 2nd the operated parts healed by first intension, 
leaving only a granulating surface about the size of a bean at the root of the nose to 
which boracic acid and vaseline was applied. On the 16th of the same month, every 
wound had healed completely. However, the sight of the right eye remained very 
weak, the patient being hardly able to read No. 200 of Snellen's type at a distance of 
4 feet. On ophthalmoscopic examination a grayish-white scar was found on the upper 
and outer part of the optic disc which presented folds radiating from the scar by the 
puckering of the retina. Besides, several other sad sequelae were left such as divergent 
strabismus, flattening of the nose, closure of the right nasal meatus and dulness 
of the sense of smell and paralysis of the right cheek. On the 24th of April, he was 
invalided from the service for life, and granted a pension according to the regulation. 



the illustration) 





^r 



^ 



S. IKEBE. ABLE SEAMAN. AKITSHIMA I.J S 
PENETRATING WOUND OF THE FACE WITH FRACTUKE OF THE NASAL BPNES. 



INJURIES OF THE FACE. 93 

(C) INJURIES OF THE EYE. 

107.— Contusion of both eyes with contused wound of the left knee 
and abrasion of the ehest and lower limbs : — S. Kaga, aged 24, a man to No. 1 
Q. F.-gnn of the Akagi. In the battle of the Yellow sea on September 17th, 1894, he 
was firing the No. 1 Q. F.-gun on the starboard side of the bridge, when a 15 cm. ? 
shell came from the stern and passed away about a foot in front of his eyes, and burst 
against the support of the gun. Some fragments of the shell hitting him, he re- 
ceived abrasions over the outer part of the left clavicle, and on the lower limbs, and a 
lacerated wound on the left knee ; at the same time, both eyes lost their sight. On 
examination there was found congestion of the conjunctiva? of both eyes attended with 
pain. This was especially the case with the right eye, but no injury to the lids and 
balls could be discovered. The wound of the left knee was a lacerated one in a 
crescent form 5 cm. long running straight downward from just above the patella : 
it reached to the periosteum yet without causing attrition of the membrane or injury 
of the bone. Other wounds were found in the following parts — two small abrasions 
just below the last wound in front of the left leg ; an oval shaped abrasion 6 cm. in 
diameter on the outer side of the right thigh ; four small abrasions in front of the 
middle part of the right leg. To the eyes, a compress of boracic lotion was applied 
and antiseptic dressings to the other wounds. On the 19th he was removed on board 
a transport and admitted to Sasebo Naval Hospital on the 21st. At the time, the 
margins of the wound at the knee were slightly inflamed, attended by a little discharge. 
In the case of the other wounds, as there was no suppuration, they dried up but the 
conjunctivae in both eyes were inflamed, the cornea of the right eye became turbid, and 
the lenses of both eyes cloudy, and vision was completely lost so that the light could 
not be distinguished from the dark. As the pains in both eyes were intense, atropine 
was dropped and a cold compress of boracic lotion was applied. On the 26th, the 
irritative symptoms of the eyes abated so that they could now be minutely examined : 
the right eye was congested all over, the cornea slightly dimmed with ciliary conges- 
tion, the iris presented a serrated appearance owing to the posterior synechia at the 
upper part of the free margin. The lens was partly dislocated towards the nasal side 
and had became somewhat turbid, presenting a slightly grayish colour. The sight 
was found scarcely enough to perceive the movement of fingers in front of the eye. 
With the left eye, the dilation of the pupil was the only abnormality that could be 
recognized with the naked-eye ; but with the ophthalmoscope detachment of the 



94 INJURIES OF THE FACE. 

retina was discovered, and tbe disc presented an irregular square snap?, and in its 
neighbourhood retinal haemorrhage bad taken place. On the nasal side of the disc 
both detachment and haemorrhage were more marked. The sight was so far destroyed 
that light could not be distinguished from darkness. As to the treatment of tbe eyes, 
leeches were applied on the temples in addition to the measures already mentioned. In 
October the congestion of the eyes greatly abated but without signs of tbe sight 
being restored. By the 13th of October, all the abrased wounds had nearly healed by 
scabbing, with the exception of the lacerated wound of the knee which was however 
now growing a favourable granulation. In order to promote the absorption of the 
effusions in the eyes, hypodermic injection of pilocarpine and internal use of iodide of 
potassium were tried. On the 28th, the injured man was removed to the Kure Naval 
Hospital, where the lesion of the knee progressed favourably, and at last healed by 
cicatrization on February 10th, 1895. The symptoms of irritation in the eyes had 
entire!} - disappeared so that congestion and pains would probably not come again, yet 
both eyes were blinded without any hope of recovery. The injured man was there- 
fore invalided for life on the 11th April, and granted a pension according to the 
regulations. 

]">. — Contusion of the right eye with lacerated wound of the right 
arm : — T. Sato, aged 27, Chief Navigating Officer of the Akagi. In the battle of the 
Yellow sea, he stood on the middle of the bridge commanding the movements of the 
vessel in lieu of the Captain who had just been killed, when a shell came by the stern 
and struck the after netting on the starboard side of the bridge. By some of the iron 
and wooden fragments thus broken off, he sustained injuries to the right eye and arm. 
Conditions of the wounds : — there was a small and superficial abrasion on the right 
upper lid attended by the congestion of the ocular conjunctiva and pain, which 
prevented the lid from opening. However, no marked injury was recognized in the eye- 
ball. On the outer side of the middle part of the right upper arm. there was a flap- 
shaped lacerated wound of 3 cm. in length and 1 cm. in depth, at its bottom tb 

i he seen a piece of black cloth ; and the wound bled freely. Besides, an oval- 
shaped abrasion, 5 cm. in diameter was found below the last named wound. The 
foreign body in the wound was extracted, antiseptic dressing was applied : and to tbe 
right eye, a compress of boracic lotiou. Then the injured officer went hack straight 
to his post. The next day the eye baudagewas removed and the right eye examiu 
There was blond effusion in the anterior chamber so that the lower half of the cornea 



INJURIES OF THE FACE. 95 

presented a crescent of a dark reddish colour and the sight was greatly obscured. 
Three days after, the effusion had much abated, and on the 23rd it was almost entirely 
absorbed to the consequent revival of sight. Though the abrasion of the upper arm, 
wis healed ; the margin of the lacerated lesion in the middle part of the arm. 
presented a sloughy condition with discharge of pus, aud the granulation of the wound 
was of a dull nature. Iodoform was sprinkled on, and a carbolic gauze applied. On 
October 1st, the abrasion of the eye-lid healed by scabbing, and the effusion of blood 
in the anterior chamber was completely absorbed, but tli • patient complained of 
epiphora aud mucoe volitantes when he looksed steadily at anything. On the 3rd. the 
slough of the wound on the upper arm had quite come off, and granulation developed, 
so as to make the surface even ; and the pus discharge had decreased. The vision 
being now-ijp, there still existed mucoe volitantes. The eye bandage was therefore 
replaced by an eye-shade. On the 27th, the wound of the upper arm healed by 
cicatrization and the injured eye exhibited a slight external strabismus, bnt as 
sight was almost entirely restored, treatment was discontinued. 

109. — Contusion of the left eye aud contused wound of face:— T. Takano, 

aged 20, a junior engineer of the Tenryii was at the time of the bombardment of the 
eastern forts, Liukung island on February 11th, 1895, on duty in the engine room, 
when a hostile shell exploded against the gear of the No. 2 port side-gun on the waist 
of the upper deck and thus broke the deck plank. Some of the wooden splinters fell 
down into the engine room, and inflicted a contused wound 4.5 cm. long and 1 cm. 
wide reaching to the periosteum over the part below the left frontal eminence 
extending through the middle of the eye-brow to the left upper lid. The margins of 
the wound were raggedly torn aud there was a slight hoemorrhage, the upper and 
lower lids being remarkably swollen. On examination of the eye, an effusion of 
blood under the conjunctiva aud into the anterior chamber was noticeable, the corn 
was cloudy, so that the sight was entirely lost. The right eye presented no striking 
change but a slight congestion. Next, there was an abrasion 3 cm. square below 
the left malar arch, in which many tiny wooden splinters like pins were found 
sticking. These being extracted, the wounds were washed with carbolic lotion, and 
then corrosive gauze was applied. On the same day, the injured officer was taken on 
board the hospital ship Kobe-maru. On the 13th : the swelling of the eye-lids had 
somewhat subsided, but the conjunctiva produced a marked swelling and the cornea 
remained cloudy. Ou the 14th : the wound 011 the cheek healed under the scab, and that 



gj INJURIES OF THE FACE. 

of (he forehead developed granulation so that it was partly covered by epithelium, but 
the condition of the left eye remained as before. On the 20th, the injured officer 
was sent to the Sasebo Naval Hospital. At the time, the wound of the forehead had 
partly healed. The upper lid of the left eye was strikingly swollen and hung down 
over the lower which was itself tumefied. On examination the conjunctivae were 
inflamed, especially that of the eye ball was greatly swollen over-lapping the margin 
of the cornea, making it seem as if the cornea had sunk into the interior of the ball. 
The cornea was grayish and opaque and pain was felt in the eye. The right eye had 
conjunctival congestion, with photophobia. The wound of the eye-brow was covered 
with carbolic gauze ; and the eye was washed with boracic lotion ; the swollen 
conjunctiva? were scarified and cold boracic compress was applied. On the following 
24th, the conjunctivitis of the lids was intensified, there was great pain and swelling, 
so the part was scarified again ; and a dose of a mild purgative was administered. 
Thus the pain of the eye was slightly mitigated, yet the swelling remained as before. 
On March 2nd : the swelling of the left eye subsided gradually. The wound of the 
eye-brow had a very slight discharge with favourable granulation and was greatly 
contracted. The congestion of the right eye had not quite disappeared. On the 13th, 
it was found that the tumefaction and pain of the left eye had greatly abated. The 
sight was so entirely lost that light and dark could not be distinguished. The cornea 
was quite opaque so that the fundus could not be examined. On the 21st, the wound 
of the eye-brow cicatrized successfully. The conditions of the left eye continued the 
same. The right eye had a slight congestion with photophobia and Iacrimation. In 
addition to the previous prescription, a weak solution of sulphate of zinc was dropped 
in the right eye and iodide of potassium administered internally. Fom that time 
the inflammation of the eye-lids and conjunctiva? subsided by degrees, but 
the left eye-ball gradually withered and n^hi came on now and then with 
aggravation of congestion. The congestion of the right eye obstinately resisted all 
remedies. Thus the left eye had entirely lost its function, and it served only to 
cause irritation ot the healthy eye, so the enucleation of the eye was performed 
on the 24th of April under an anaesthetic. The enucleated eye-ball was atrophied to 
the size of the tip of the index-finger. The conjunctiva and muscles of the eye were 
indurated ; oil section the eye was found to he as hard as a cartilage ; the choroid and 
vitreous body were pn sent, but the lens had disappeared, and the optic disc had con- 
tracted to the size of a linseed. After the operation the progress was favourable. On the 



INJURIES OF THE FACE. 97 

3rd of May, the interior of the orbit was clean, presenting no suppuration. On the 
13th, the margin of the wound healed by the first intention. Hence, the congestion 
and photophobia of the right eye greatly abated, but headache occurred intermittently. 
On the 27th, it ceased entirely as well as the congestion of the right eye ; an artificial 
eye graciously bestowed by H. I. M. the Empress was applied and on June 6th, he left 
the hospital and returned to his duty, but was afterward by his wish, invalided for life 
with the grant of the regular pension. 

110. — Penetrating wound of the right eye with burns of face, left hand 
and loin : — -S. Ogawa, aged 26, one of the crew to 32 cm. gun of the JIatsushima. In 
the battle of the Yellow sea on September 17th, 1894, he was firing in the tower of 
the said gun, when a shell struck against the wall of the tower and burst. One of the 
iron fragments thus broken, penetrated the inner canthus of the right eye causing 
extravasation of blood in the anterior chamber. He also sustained burns of the 
second degree from explosion-gas on both ears, on the left forearm and hand and on 
the left lumbar-region. Directly after the accident, a boracic wet compress was ap- 
plied to the eye, and an oil lint to the burns, strict rest being ordered. The injured 
man was sent to the Sasebo Naval Hospital on the 20th. Examination at the hospital : 
a small lacerated wound near the inner canthus of the right lower lid was found 
which perforated through the all the layers of the lid, and entered into the inner and 
lower part of the eye-ball. The conjunctival congestion and the effusion of blood in 
the anterior chamber prevented the examination of the fundus. On the 28th, the 
laceration of tlte right eye-lid had healed, and the surfaces of the burns developed a 
new epithelium though there remained several suppurating points. On October 14th : 
the burns of the ears and the left fore-arm had healed completely while that on the 
loin left an ulcerated surface about the size of a two sen copper piece. The congestion 
of the conjunctiva had diminished and the extravasation of blood into the anterior 
chamber was being gradually absorbed. On the 19th, the burn of the loin had healed, 
and blood effusion in the anterior chamber was being, by degrees, absorbed ; the 
fundus could hardly be examined owing to the turbidity of the aqueous humour, but 
the presence of a deep blue spot on the temporal side of the interior of the eye was 
recognized. November 6th : the aqueous humour became almost transparent so that 
light and dark could be faintly distinguished. The eye-ball had gradually shriveled 
and the upper lid dropped down. December 20th : the aqueous humour was cleared 
up by the absorption of its turbidity ; the iris had the posterior synechia, the pupillary 



93 INJURIES OF THE FACE. 

margin presented a serrated appearance, the fundus could be seen without the aid 
of an ophthalmoscope, thus evidencing that the lens was absent ; at the outer and 
lower part of the fundus, an old striated patch of blood extravasation was found 
which proved to be what had been before recognized as a deep green spot. The 
eyes however remained almost blind ; indeed, the eye had undergone no remarka- 
ble change since the first, but there appeared occasional symptoms of inflamma- 
tion. Thus no hope of recovery of the sight could be expected, while if the eye 
was left in that state, there was reason to fear the occurrence of sympathetic 
ophthalmia. Therefore the injured eye was extracted on March 9th, 1895. When 
examined after the enucleation an iron fragment about the size of a bean was 

found concealed in the sclerotic at the outer and 
lower part of the ball (see the illustration No 2 
the lens was dislocated downward : the retina detached 

Fig. 2. Iron fragment which had w itb an effusion of blood on its outer and lower side : 
penetrated into the right 

eye-ball. the eye-ball had collapsed. After the operation, the 

course was favourable. On the 28th May. the injured mau had the honour of having 

an artificial eye graciously presented to him by U. I. M. the Empress. On the 

14th June he was put on the list of the invalided for life, and left the hospital. 

He was then granted a pension in accordance with the regulation. 

1 11. — Penetrating wound of the left eye, blind wound of left leg, and 
lacerated wounds of left fingers:— V. Tanaka, aged 25, one of the crew of the 
No. 5. side-gun of the Akitsushima. In the battle of the Yellow sea on Septem- 
ber 17th, 1894, he was engaged in carrying cartridges in the neighbourhood of 
the starboard No. 5 side-gun on the waist deck, when a hostile shell exploded 
against the shield of the gun. By the explosion, he sustained a slight burn on 
the face, some gnu-powder sticking into the skin, and at the same time small iron 
fragments and gun-powder penetrated into both eyes, and he had a lacerated wound on 
the nasal side of the left eye. which reached deep down into the interior. An effusion 
of blood ensued in the anterior chamber causing entire loss of sight of the eye. The 

i of the right eye remained unaffected. On the iunei- side at the upper third of 
the left leg, tli eiv was a lacerated aperture as large as the tip of the index-finger. 
The aperture ran beneath the gastrocnemius outward and down-ward measuring 7 cm. 
in its length. There was also a lacerated wound on the ulnar side of the left index- 
finger, and the second phalanx of the left little linger was crushed. The eyes were 



INJURIES OF THE FACE. 99 

washed with a boracic lotion ; foreign bodies were extracted from them and wet com- 
presses of boracic acid were applied : the other wounds were dressed with carbolic 
gauze. On the 19th, the injured man was sent on board a transport, to the Sasebo 
Naval Hospital. At the time of admission, the conjunctiva of the left eye was swollen ; 
the anterior chamber presented a dark reddish colour owing to the effusion of blood ; 
the pupillary region was clouded and of a yellowish colour ; the opening of the conjunc- 
tival wound had already healed. The conjunctiva of the right eye was congested ; the 
cornea and lens were sound ; the sight was not impaired, but the pupil was somewhat 
dilated, and the reaction to light was very slow. The wounds on the left fingers and 
the left leg were of a gray colour on the surface, with a slight discharge of pus. On 
the 26th the presence of a foreign body in the wound of the leg was found by probing ; 
a counter opening was made on the outer side, and a fragment of shell about the size 
"i the tip of the thumb was extracted. The crushed portion of the little linger was 
covered by granulation. On the 11th of October, the congestion of both eyes greatly 
abated, and the vision of the right eye improved, yet muscae volitantes was complained 
of. The effusion of blood in the anterior chamber of the left eye underwent absorp- 
tion, yet the opacity of the cornea existed as before to the complete loss of sight. A 
mild purgative was given and leeches applied to the temple. On the 25th the left 
eye underwent slight atrophy aud presented no signs of the recovery of sight. The 
vitreous body of the right eye was found to be clouded, aud the lens of the left eye 
was found to be quite opaque and ot" a yellowish gray colour (traumatic cataract). 
The use of a moderate quantity of iodide of potassium was continued. On the 27th, 
the surface of the crushed wound of the little finger became cicatrized ; the canal 
wound on the leg was filled with granulation aud the surface contracted. On the 
28th of December, the wound on the outer side of the leg healed. The left eye in- 
creased its degree of atrophy. The sight of the right eye gradually recovered its 
power, and the nauseas volitantes was greatly relieved. On the 6th of January, 1895, 
the wound on the inner side of the left leg healed. But owing to the contraction of 
the cicatrix the knee joint assumed an angle 1 f I'm so as to hinder proper movements. 
Spirit of camphor was applied and active and passive movements of the joint were 
encouraged. Ever since the left leg has gradually increased the degree of flexion and 
extension, yet in walking, a stick was found necessary. Signs of the eyes : — the sight 
of the right eye fell a little short of ~-~ ; the musca? volitantes still remained. The 
atrophy of the left eye increased noticeably and, was attended by occasional irritative 



100 INJURIES OF THE FACE. 

symptoms. It was thought that there might exist some foreign body in the eye-ball, 
so on the 25th of May, the left eye was extirpated ; on examination, a small fragment 
of shell covered with rust and weighing 0.95 gramme was found inserted between the 
choroid and sclerotic, on the part corresponding to the lower and outer part of the 
papilla. On the 31st of May, the wound of the eye healed. On the 7th of June, au 
artificial eye graciously presented by H. I. M. the Empress was put in. The sight 
of the right eye remained at ^$ but muscae volitautes had greatly abated. On 
examination, it was ascertained that the turbidity of the vitreous body was nearly 
absorbed, but the veins of the papilla were swollen, and its inner margin presented 
an cedematous appearance. The retina was also congested. These neuritic symp- 
toms persisted notwithstanding appropriate treatment. On the 27th of July, the in- 
jured man was invalided for life, and left the hospital with a grant of pension accord- 
ing to the regulations. 

(D) INJURIES OF THE EAR. 

112.— Rupture of niembrana tympani of both ears:— T. Omori, aged 29, 
belonging to the crew of the starboard Hotchkiss gun of the Itsukushima ; in the battle 
of the Yellow sea on September 17th, 1891, was at work on the fort of the starboard 
Hotchkiss gun on the uppermost deck, when by the shock consequent to the firing of 
the 32 cm. gun, the membrana tympani of both ears were broken. By inspection 
with the speculum, the tympanic membrane of the left ear was uneven, with loss of 
brightness, the congestion was marked at its upper part, and a small perforation found 
in front of and above the central depression. The membrane of the right ear was 
perforated below the centre ; perforation being somewhat smaller than that of the Left, 
and the margin smooth. Hearing was greatly impaired in the left ear, while that 
of the right was but slightly deranged. An antiseptic cotton wool plug was inserted 
in the meatus, and the patient was ordered to keep a strict rest. In due course, the 
lacerated wound of the left tympanic membrane formed union, while the perforation 
of the right ear remained ununited. However, no marked impairment of bearing 
existed. The treatment was discontinued on the 20th of October. 

113. — T. Uramoto, aged 21, one of the crew of the starboard Hotchkiss gun of 
tbe Itsukushima, in the same battle as above, was on the port side of the Hotchkiss 
gun on the uppermost deck, when by the vibration of the firing of the 32 cm. gun, 
he sustained perforation of both membrana tympani. On examination, two irregular 



INJURIES OF THE FACE. ]Q1 

perforations about the size of a linseed were recognized above and behind the mem- 
brana tympani of the left ear, and a linear laceration extending vertically from the 
middle of the right tympanic membrane. Both membranes presented a slight conges- 
tion with slight pain but the hearing was only impaired in a slight degree. Antiseptic 
cotton wool was inserted in the meatus and the wounds healed on October 17th. 

114. — S. Nakamura, aged 39, Lieutenant of the Naniwa was during the same 
engagement as above, commanding the starboard battery, when owing to the vibration 
of the discharge of the gun the tympanic membranes of both ears were ruptured. On 
examination, a small lacerated hole in each ear was found at the point a little above 
and behind the centre of the membrane, attended by a slight bleeding and loss of 
hearing. The meatus was protected with antiseptic cotton wool. On the 30th of the 
same month, these lesions healed, but resulted in the induration of the membranes and 
consequently dulness of hearing. 

115. — Kupture of right tympanic membrane : — T. Hikiji, aged 21, one of 
the crew of a Hotcbkiss gun of the Hashidate, was in the same engagement as above, 
engaged in tiring upon the enemy's ships from the fort of the Hotcbkiss gun in the 
rear of the uppermost deck, when owing to the shock of firing he felt a severe pain in 
his right ear, which has ever since been followed by impaired hearing and ringing in the 
ear, with a thin turbid discharge. When the ear was washed and examined with the 
speculum the membrana tympani wore found to be perforated, — that is, a small ver- 
tical lacerated slit with a smooth margin was found in the front and lower part of the 
centre of the membrana tympani. The membrane was congested, and turbid, the power 
of hearing greatly impaired showing only ^\. The meatus was washed with boracic 
lotion ; boracic oil dropped into the ear, and an antiseptic cotton plug was inserted. 
On the 30th of the same month, the discharge ceased, and the ringing in the ears 
somewhat decreased. On October 11th, the lacerated wound of the membrane healed 
leaving induration and turbidity with a power of 5 '& of hearing. As it was hoped that 
the hearing would gradually attain a normal standard, the treatment was discontinued 
with the exception of the cotton wool plug which was still applied. 

110. — K. Saito, aged 27, was one of the crew of a gun of the Yoshino. In the naval 
engagement of Phung-do on July 25th, 1894, while firing upon the enemy's vessels, the 
membrana tympani of the right ear was perforated owing to the vibration of the dis- 
charge of the gun. On examination, a laceration of the size of a pin's head was re- 
cognized in the front and lower part of the membrane. An antiseptic cotton wool plug 



]02 INJURIES OF THE FACE. 

was inserted in the meatus. On August 2nd, there was a slight discharge from the 
canal. On examination, the membrane presented turbidity with congestion around 
the laceration. The auditory passage was washed with a boracic lotion and a corrosive 
cotton wool plug was inserted. On the 13th following, the discharge ceased and the 
laceration healed ; washing of the passage was stopped, and on the 18th, the 
hearing was nearly restored. 

117. — T. Nagayama, aged 23, one of the crew of a gun of the Yoshm- during 
the naval fight of Phung-do on July 2.1th, 1891, while tiring upon the enemy's 
vessels, had the tympanic membrane of the right ear ruptured by the shock consequent 
on the discharge of the gun. Pain in the ear and impaired hearing were complained 
of. The speculum showed a lacerated hole a little above the middle of the membrane. 
The margin of the slit as well as the auditory canal were congested. An antiseptic 
cotton wool plug was inserted and the case healed on the 7th of August. 

US. — Rupture of right tympani: membrane with burns of face :— 
K. Saito, aged 25, belonging to the crew of No. 8 machine gun of the Naniwa was 
in the naval engagement of Phung-do on July 25th, 1891, standing by the No. 8 
machine gun on the after part of the port side, when by the ejection of gas due 
to the discharge of the adjacent 12 c. m. gun. slight burns on the right temporal 
region and external ear were sustained. The right tympanic membrane was 
ruptured ; a mixture of boracic acid and olive oil was applied to the burns ; and 
an antiseptic cotton wool plug was inserted into the ear. On August 5th, the 
burns healed, and on the 20th the lesion of the membraua tympani recovered. 

119.— Rupture of left membra tympanum :— M. Matsnoka, aged 27. In 

the naval engagement of the Yellow sea fought on September 17th, 1894, he was 
on the fort of the starboard llotchkiss gun of the uppermost deck ol the Itsuku- 
shima auds ustaiued a laceration of the left tympanic membrane by the shock of 
firing the 32 c. m. gun. On examination with the speculum, a perforation about 
the size of a linseed was found on the upper and back [nut of the membrane. The 
membrane was congested with loss of brightness and ringing in the ear and 
impaired hearing was complained of; (power of hearing being by a watch -^-j-J); 
an antiseptic cotton wool plug was inserted in the meatus, and patient was ordered 
strictly t'> rest. On October 17th. the lacerated wound of the membrane healed 
and I..'- i eai ina w;is resl '1. 



IXJ CRIES OF THE FACE. 103 

120. — K. Iwatuoto, aged 26, belonging to the crew of the starboard Hotcbkiss 
gun of the Itsukushima, was in the same battle as above, on the fort of the 
Hotchkiss gun of the uppermost deck, when the shock of firing the 32 c. id. 
gun, ruptured the left tympanic membrane. By using the speculum, a small 
perforation was recognized in the middle of the membrane. There was congestion 
around the perforation, and the hearing was slightly impaired. An antiseptic 
cotton wool plug was stuffed into the meatus. The case recovered on October 
19th. 

121. — K. Takeda, aged 21, belonging to the crew of starboard Hotchkiss 
gun of the Itsukushima was, in the same battle as above on the fort of the 
Hotchkiss gun on the starboard upper deck, when by the shock of firing the 
1 2 c. m. side-gun on the lower deck he sustained rupture of left tympanic 
membrane. On examination with the speculum, a grain sized perforation 
was found on the membrane. The membrane was slightly congested, and the 
hearing a little impaired. An antiseptic cotton wool plug was stuffed in the 
meatus and the case healed on October 17th. 

122. — T. Hirai, aged 24, Midshipman of the Yoshino was in the same 
battle as above, acting as recorder of the engagement standing in the coning 
tower at the bow. By the vibration of firing the bow gim the rapture of 
the left tympanic membrane was sustained. On the 20th of the same month, 
an examination with the speculum revealed a lacerated hole on the part a 
little behind the centre of the membrane which was congested and turbid ; 
the hearing was almost entirely L»t (the power of hearing by a watch being 
7jnr)i but without any pain or discharge. An antiseptic cotton wool plug was 
inserted into the meatus. On October 0th, a slight discharge came from the ear. 
The canal was washed with boracic lotion, and a mixture of boraeic acid and 
olive oil dropped into the ear. At the end of the same month, the discharge had 
almost ceased ; the lacerated wound of the membrane healed and the congestion 
disappeared, but the turbidity of the membrane still remained and the hearing was 
not entirely restored ( T 3 °ir)- ® n tne ^th " f November, the symptoms were greatly 
dhe treatment ceased. 

123. — F. Takehara, aged 26, one of the gun crew of the Yoshino was 
in the naval battle of Phung-do on the 25th of July, 1894, engaged in firing 



104 INJURIES OF THE NECK. 

on the enemy's vessels, when by the shock of the discharge of the gun the 
left membrana tympanum was ruptured. By using the speculum a transversely 
lacerated hole was recognized at the upper part of the membrane. An 
antiseptic cotton-wool plug was inserted into the meatus. Some days after, the 
auditory canal-became congested and a slight discharge with impairment of hearing 
and ringing in the ear was complained of. The canal was washed out with 
boracic lotion, and a mixture of boracic acid and olive oil dropped into the ear. In 
the middle of August, the discharge ceased, and the hearing was gradually restored, 
though the perforation of the membrane still remained. Washing of the ear was 
given up, while dropping of the boracic oil still continued. The case healed on 
the 31st of August. 

4— INJURIES OF THE NECK. 

(A). INJURIES OF THE SKIN AND SUPERFICIAL MUSCLES. 

124.— Abrasion of the neck : — S. Mukoyama, aged 38, Commander of the 
Matsushima. In the battle of the Yellow sea on September 17th, 1894, was standing 
on the after bridge, when a shell from the enemy exploded against the tower wall 
of the 32 cm. gun. The fragments of the shell caused an abrasion on the right 
side of the neck. Corrosive gauze was applied. On October 3rd, the wound healed 
by scabbing. 

125. — Abrasion of the neck and chest :— T. Imamura, aged 20, a seaman of 
the Itsukushima. In the naval engagement of the Yellow sea on September lTtli. 
1894, acting as a magazine party of 12 cm. gun, was standing behind the bow-gun 
battery on the upper deck, when a hostile shell penetrated through the port netting 
in the fore part and exploded. An abrasion 3 cm. in diameter was caused by some 
fragments on the left side of the thyroid cartilage, another, of the size of a 5 tin copper 
piece, at the right hypochondriac region. Sublimate gauze was applied; and the 
lesions healed under scabs on October 9th. 

126.— Penetrating wound of the neek with abrasion of right arm and 

burns of the neck : — H. Arima, aged 21, a cook of the Matsushima. In thi' battle 
of the Yellow sea on September 17th, 1891, was engaged as a shell carrier of the after 
magazine ; while taking a short repose on the chest in the middle part of the lower 



INJURIES OF THE NECK. 105 

peck, a hostile shell knocked through the torpedo-chamber in the larboard-waist, 
the severed fragments of the wood inflicting a penetrating wound on the right side of 
the neck below and behind the mastoid process ; also burns of the first degree, extend- 
ing from the right side of neck to the right shoulder were inflicted by the explosion 
of the shell. Besides, small abrasions at the upper and lower parts on the outer sides 
of the right arm and fore-arm were sustained. A temporary dressing was applied in 
the ship, and the injured was sent to Sasebo Naval Hospital on the 20th. On 
admission the burns had already healed ; the wound on the right side of the neck 
measured 3 cm. in depth and discharged pus. On probing the wound two small 
wooden splinters were found and extracted. The wounds were washed with a carbolic 
lotion, and bandaged with sublimate gauze. On the 25th all the abrasions of the 
right arm had healed, but the lesion of the right side of neck presented unfavourable 
granulation, with copious discharge. On October 10th, the granulation of the ueck 
wound was somewhat improved, though the discharge was still copious. About the 
middle of November the discharge began to decrease and the granulation developed 
favourably. On January loth, 1895, cicatrization was at last accomplished, and the 
patient left the hospital on the 20th. 

(B). INJUBIES OF THE DEEP PABTS. 

127. — Penetrating wound of the neck : — M. Imai, aged 22, a cook on board 
the Itsukushima. In the battle of the Yellow sea on September 17th, 1894, was 
acting as a magazine party of 32 cm. gun, while he was passing along the front part 
of the upper deck, a shell exploded through the larboard netting in the fore part of 
the ship. One of the fragments penetrated through the trachea and oesophagus ; at 
the same time, severing the right carotid artery. Death was immediate from copious 
bleeding. 

128.— Perforating wound of the neck with destruction of the left eye 
ball : — C. Sato, a member of torpedo magazine of the Itsukushima, aged 23 ; at the 
battle of the Yellow sea, on September 17th, 1894, was in the fore-torpedo-chamber, 
when a hostile shell exploded against the boom for the use of the starboard torpedo 
net ; some of the shell fragments entered the said chamber after smashing the ship's 
side and inflicted a perforating wound on the right side of the neck, which took the 
passage beneath the stemo-mastoid from the right side of the thyroid cartilage, perfo- 
rating the second cervical vertebra. The cornea and sclerotic of the left eye were 
destroyed, the lens escaping. There were besides several burnt patches on various 



]06 INJURIES OF THE CHEST AND BACK. 

parts of the face and trunk. The carotid artery escaped injury, yet a copious bleed- 
ing from the wound of the neck caused enfeebleiuent of the pulse, but the mind re- 
mained clear without any sign of shock. The bleeding vessels were ligatured at once, 
an antiseptic dressing was applied, and a stimulant given internally. The tempera- 
ture rose high ; nausea, vomiting and drowsiness ensued, and at length he succumbed 
from coma at 2. '25 a.m. on the 19th. 

129.— Lacerated wounds of the neck, abdomen and lower limb with 
extensive burns of the body : — S. Mnroyn, aged 20, one of the crew of No. 4 gun 
of the Hiyei. While he was firing the gun at the battle of the Yellow sea, on Septem- 
ber 17th, 1894, a shell came over the netting of the starboard waist, and burst against 
the stanchion of the port booms ; the fragments wounded him on the neck, abdomen 
and lower limbs, the neck was deeply lacerated, the larynx and the carotid vessels 
on both sides were mutilated, the lower jaw smashed, and the abdomen and lower 
limbs sustained several lacerated wounds. To make the matters worse, some of the 
fragments driven about ignited the powder-case carried by another member of the 
same gun crew. The fire thus caused caught the garment of the injured and inflict- 
ed burns over the greater part of the body so that he died on the spot. 

5.-INJURIES OF THE CHEST AND BACK. 

(A) INJTTJES OF THE CHEST WALL. 

130.— Contusion of the chest with burns of the face :— J- Tanaka, aged 
19, a bandinan on board the flagship Matsnshima, in the battle of the Yellow sea. 
September 17th, 1894, was acting as bearer of the wounded. He was passing the 
tarboard side in the fore part of the upper dock, when an enormous shell burst 
against the shield of the No. 4 port gun in the fore part of the lower deck, at the 
same time igniting the ammunition provided lor the use of the side gun. One of the 
fragments of shell hit him on the upper part of the sternum, and inflicted burns of 
the second degree on the left side of the lower jaw by the explosion flame. A tem- 
porary treatment was given on hoard the ship, and on the 20th, he was admitted to 
Sasebo Naval Hospital; from that time the wounds progressed favourably, and the 
patient recovered on the 26th 

181.— Contusion of the right side of chest:— Y. Murao, aged 20, one of 
the crew of the lore revolving gun of the Katsuragi, at the time of the bombardment 
of the eastern forts of Liukung Island, on February 11th, 1895. He had just turned 



INJURIES OF THE CHEST AND BACK. ]07 

the said gun, when be was knocked down on the deck by the shock of a hostile shell 
which hit the barrel of the gun : and sustained contusion on the right hypochondriac 
region. He complained of pain in the part on breathing and bending or extending 
his trunk, but there were no objective signs to be seen. Spirit of camphor was ap- 
plied over the part ; and rest was ordered ; he recovered on the 14th. 

132.— Contusion of the left side of chest :— M. Yoshiznka, stoker belong- 
ing to the Akitsushima, aged 22, in the battle of the Yellow sea, was descending the 
ladder of the engine room, when, by the shod; of the firing of the ship's gun, he was 
thrown down into the said room and sustained contusion on the left side of chest. 
Symptoms of concussion were marked and he became unconscious. Eesuscitation 
was immediately resorted to, and on examining the part no ecehymosis nor fracture 
were found. The thoracic organs were intact. Lead lotion was applied to the chest, 
and strict rest ordered. The patient recovered on the 4th day. 

133.— Contusion of the chest with burns of face, neck and hand: — 
C. Inouye, one of the crew of the fore torpedo tube of the Matsushima, aged 24, at 
the battle of the Yellow sea, on September 17th, 1894, was in the fore torpedo cham- 
ber, when a shell burst in the fore part of the lower deck, and at the same time the 
ammunition provided for the use of the side gun exploded. Fragments of shells 
and explosion gas were thus forced into the said room, the fragments of shells con- 
tusing his left hypochondriac region and the right knee joint. The left half of the face, 
the neck and the backs of both hands sustained burns of the first degree. Temporary 
treatments were applied on board the ship, and the injured man was sent to Sasebo 
Naval Hospital on the 20th. At the time the burns had already healed ; but the contu- 
sion of the chest had caused an abrasion. The part was swollen, and he complained of 
pain at the time of deep breathing and of extending or bending the body. The knee 
joint presented no abnormality but slight pain was complained of walking. Lead lotion 
was applied and rest enjoined. He left the hospital recovered, on October 10th. 

134— Contusion of back, right forearm and left leg:— Y. Uramoto, 

aged 24, one of the crew of the top-gun of the Matsushima, in the battle of the Yellow 
sea, on September 17th, 1894, was passing the port side of the lower waist deck car- 
rying shells for the top-gun, when ,a 30.5 cm. hostile shell burst in the fore part of 
the lower deck ; some of the fragments struck him on the right inter-scapular region 
causing blood extravasation of the size of a one yen silver piece ; slight contusions on 
the outer side of the right fore-arm and in front of the left leg were also sustained. 



108 INJURIES OF THE CHEST AND BACK. 

Lead lotion was applied followed by the application of spirit of camphor. He recover- 
ed on October 9th. 

135. — Abrasion of right side of chest with contusion of right ing- 
uinal region : — M. Takehara, aged 34, petty officer acting as a member of the 
machine gun magazine of the Hiyei, in the battle of Yellow sea, on September 17th, 
1894, was lifting shells at the entrance of the said magazine on the rear beneath the 
lower deck, when a 30 5 cm. hostile shell exploded in the ward-room on the lower 
deck just above the magazine. The fragments of shell and broken pieces of the ship's 
planks fell into the magazine, and he received an abrasion from a wooden splinter on 
the right side of chest close to the sternum, while a fragment of shell knocked him on 
the right inguinal region. Luckily, owing to the presence of a' tobacco pouch (with a 
metalpipe) in the pocket of his coat, the fragment (of an irregular triangular shape) 
having pierced through the coat and the tobacco pouch, was stopped by the pipe 
which was bent into the shape of < the kana-lettev (See the wood-cut No. 3); but 
an irregular oval shaped subcutaneous extravasation at the middle of Poupart's liga- 
ment was produced. By the application of lead lotion, the lesions were cured on the 
21st of the month. 

133. — Abrasion of the back : — S. Omnia, aged 23, one of the crew of No. 3 
12 cm. gun of the Yoshino, in the battle of the Yellow sea, September 17th, 1894. 
While ho was tiring on the enemy's ships, at the fort of Xo. 3 gun on the starboard 
side of the upper deck, a hostile shell pierced through the starboard netting in the 
rear and burst on the quarter deck. Some of the fragments of shell were driven off 
so as to reach the fore part of the upper deck. One of them caused an abrasion on 
the part below the right scapula. Sublimate gauze was applied and sealed with adhe- 
sive plaster. The wounds healed on the 21st of the month. 

137.— Contused wound of the right side of chest:— Y. Harada, aged 
24, seaman of the Hiyei, in the battle of the Yellow sea, was, as one of a magazine 
party, engaged in lifting shells at the entrance of the magazine in the 3rd quarter of 
the lower deck, when an enormous shell, exploded in the ward-room on the 5th 
quarter. lie received from a fragment of tin- shell a contused wound 2 cm. long 
and 1 cm. deep, in tin- posterior boundary of the right axilla. Iodoform was sprinkled 
on and adhesive plaster applied. The wound healed on the 20th of the month. 

138.— Contused wound of left side of chest, head and left leg:— 
A. Ide, aged 28, Sub-lieutenant of the Matsushima, in the engagement of the Yellow 



Fig. 3-A (Actual siis 



x 






■ JjM* 



A. Toljaccn pouch. B. the pipe. I', fragment of shell. 

A* 




' : '*-5 









Showing the posterior aspect 
of the pouch with the fragment 



G j BJVffi ilj'*. * ^ "»' ■ ■. . il ' . ' i"" rr "^ 1 1 f i* 1 ' '' J _ ' '' ' '*»"* *' * '' 

ragment of shell s 
both surfac - 




Fig. 8-B. 



Tobacco pipe bent by the fragment of she] 

. ~~- (..-.^Lj.. . t .,v^ ' :-n - v . ! . -«s g !a^g ^.^»its;^^ ?y:-- - -■ 



igggggg^Bttg^mm** 



INJURIES OF THE CHEST AND BACK. 109 

sea, was superintending the torpedo tubes on both sides on the waist of the lower deck, 
when a hostile shell pierced through the place only a few feet in front of his face ; he was 
thrown by the shock to the side of the starboard torpedo tube. At the same time he 
sustained, from broken pieces of iron, contused wounds in the left hypochondriac region 
and in the calf of the left leg. He fainted for a while, but soon returning to himself, 
received treatment. Conditions of the wounds : at the end of the last rib there was an 
irregular lacerated wound about the size of a 2 sen copper, and in the middle of the 
calf an oval wound G cm. long and 3 cm. wide. In both cases the skin was stripped 
off, but neither the hard nor the soft tissues beneath were found injured ; bleeding was 
not copious. An antiseptic dressing being applied, he soon returned to his former 
station. An hour after the accident he was again thrown down, together with the crew 
of the starboard torpedo-tube, by the shock of explosion of ammunitions for the side- 
gun, caused by the explosion of a hostile shell in the fore part of the lower deck ; and 
sustained, from a piece of shell, a lacerated wound on the posterior portion of the 
left parietal region. It was superficial, without lesion of the skull : bleeding was rather 
profuse. Besides, both the hands and the face were marked with numberless small 
black spots caused by the powder. The wounds were washed with carbolic lotion, 
sprinkled with iodoform, and sublimate gauze applied. The wound of the head healed 
in the course of about 10 days by scab, while those of the chest and calf were much 
delayed by suppuration, and did not begin to heal until the formation of cicatrices 
commenced. The cure was completed on November 7th. 

139. — Blind wound of thoracic wall with abrasion of the left thigh :— 
K. Kodama, aged 29, a member of No. 5 Q. F. gun of the Akagi, in the battle of 
Yellow sea, ou September 17th, 1894. While firing on the enemy's ships a fragment 
of hostile shell flew in from the stern and inflicted a wound on the left side of the 
chest. On examination, the wound was found to be of an irregularly lacerated shape, 
1 cm. long and 6 m.m. wide, over the 7th rib, about 6 cm. below the left nipple; 1 cm. 
deep, reaching to the rib. There was but little bleeding, but the shock caused the 
patient to faint. On the outer side of the left thigh a small abrasion was found. Iodo- 
form gauze was applied. The patient being taken on board a transport on the 19th, 
was admitted to Sasebo Naval Hospital on the 21st. At the time, the abrasion of the 
thigh had dried up and was almost healed ; the wound of the chest discharged a 
small quantity of pus. On probing the wound, something hard was felt at the bottom. 
The wound was cut wide to about 3 cm. and a rough angular piece of shell, the size of 



HO INJURIES OF THE CHEST AND BACK. 

a bean was extracted. Then the rib was examined, lint no fracture found, only the 
stripping of perichondrium of the costal cartilage. The incised margins of the wound 
were sutured, a drainage tube introduced and carbolic gauze applied. On the 20th, the 
threads were removed as the parts had formed union ; the wound however still dis- 
charged a slight pus, though the granulation was healthy. On the 28th of Oct- 
bcr the patient was removed to the Knre Naval Hospital. At the time, there was a 
granulating surface of 3 cm. on the chest with a sinus at the bottom, leading to the 
roughened costal cartilage. A drainage tube was introduced and iodoform gauze applied. 
( >n the 18th November, the surface of the wound had contracted so as to leave merely 
a very small aperture ; but the granulation in the sinus was unhealthy, discharg- 
ing a thin pus, and the healing process was exceedingly retarded, so, by the use of a 
sharp spoon the unhealthy granulation was scraped off and carbolic gauze applied. On 
December 23rd, the granulation had not yet improved and the pus discharge continu- 
ed ; on enquiring into the past of the patient, he was found to have had a syphilitic 
history, so much so that he had even then swelling of the lymphatic glands. An appli- 
cation of mercurial ointment was consequently ordered. On January 17th, 1895, the 
use of ointment was discontinued, and internal administration of iodide of potassium 
ordered. From that time the granulation of the wound improved with gradual 
decrease of discharge, so that, towards the end of March, there remained no more than 
a quite superficial and small granulating surface. However, from the 30th of the 
same month, his mind became somewhat abnormal, showing signs of melancholia 
with sleeplessness. A mixture of bromide and iodide of potassium with occasional 
doses of chloral hydrate was prescribed, and the patient was ordered to take walking 
exercise in the open air. At last, on April 12th, the wound of the chest healed by 
cicatrization ; the mental symptoms subsiding at the same time, he left the hospital 
on May 9th, and resumed his duty. 

140.— Blind wound of the chest wall with abrasion of face and upper 

arm : — T. Saito, aged 30, gunner to No. 17 port gun of the Fnso, was wounded, at the 

' Qgag nt of the Yellow sea, on September 17th, 189 1, by some of the broken pieces of 

the funnel, the lower part of which was pierced through by a hostile shell, while he 
was resting Cl'OSS-legged ell tin' lel'i side of the funnel casing. (In examination, there 
was an oblong wound (i cm. long and 2 e in. wide on the right side of chest wall ex- 
truding from th" 7tli In tin' 9th rili. Its depth was 2 cm. (the penetrating iron piece 
bi ing exposed tie' injured man extracl ''1 it himself i, the bottom reached to the costal 



INJURIES OF THE CHEST AND BACK. HI 

cartilages, but without injuring them. Besides, on the right zygomatic arch, and ou 
the upper part of the left upper arm small abrasions were found. The wounds were 
dressed with sublimate gauze, and, on the 21st, the injured man was admitted to 
the Sasebo Naval Hospital, where, by antiseptic measures, the wounds both of the 
cheek and arm healed under scabs ou the 27th. The wound on the chest also 
developed a healthy granulation and progressed favourably, and on November 18th, 
the patient was recovered sufficiently to resume his duty. 

141. — Blind wound of the back : — K. Matsushige, aged 23, one of the crew of 
No. 2 Q. F. gun of the Akagi, in the battle of the Yellow sea, was wounded on his 
back by one of the fragments of shell that came flying to the bridge from the starboard 
bow, while he was firing the port Q. F. gnu on the bridge. On examination, there 
was a lacerated wound, 1 cm. in length and of somewhat smaller width, below the 
right scapular region. The margins were ragged, and, on probing the bottom, pieces 
of torn cloth were found lodged inside. These were extracted, and the wound was 
washed with carbolic lotion and a sublimate gauze applied. On the 19th, the dressing 
was changed, when a slight discharge of pus appeared ; ou the 22nd, the discharge 
ceased ; by the 30th, the granulation developing from the bottom became smooth. 
On examining the part 3 cm. above the wound something hard of the size of a bean was 
felt under the skin, although no pain was complained of. The part was cut open and 
a fragment of shell of in.ru. square (as shown in the illus- 
tration No. 4) was obtained. The newly incised surface was 
F'<r f t f hi] ^"ti^P'i^lly treated aud sealed with adhesive plaster ; it 

extr-ioted-from the wound Lea]ed by the first intention, while the wound of the 
on the back. 

back entirely healed with a small cicatrix on October 9th. 

1-12. — Perforated wound of the back, blind wound of neck r.nd 
lacsrated wound of right upper arm :— M. Hamaguchi, aged 24, one of the 
crew of No. 1 Q. F. gun of the Akagi, in the naval engagement of the Yellow 
sea, while firing the gun at the starboard side on the bridge, was wounded on the 
back, neck, and right upper arm by fragments of a shell which came from the stern 
and burst against the support of that gun. On examination, the wound of the back 
was found to be a grooved one 1.5 cm. deep, 18 cm. long, and 3 cm. wide, running 
from the middle of the infra-spinous region of the right scapula towards the left, 
and transversely crossing the spinal column. The bottom of the wound was as 
clean as if it had been scraped away. At 3 cm. from this wound, another wound 



112 INJURIES OF THE CHEST AXD BACK. 

was fonnd just below the left acromion process, which was round, 5 cm. in diameter 

ami with loss of substance ; the edges lacerated irregularly ; the bottom shallow, 
not reaching to the bone, but communicating under the skin with the grooved 
wound above described ; bleeding profuse. In the middle of the right side of the 
neck there was also a blind wound 6 m.m. in calibre, and 3 cm. in depth ; no 
foreign body present within. At the time of injury, a large quantity of blood was 
bn night up. Again on the outside of the lower part of the right upper arm a lacerated 
wound 3 cm. long was found. To the perforated wound of the neck, a drainage 
tube was introduced and the other wounds were dressed antiseptically. The injured 
man being taken on board a transport on the 19th, was admitted to Sasebo Naval 
Hospital on the 21st. At the time, deglutition and plionation were difficult owing 
to the wound of the nock, but there was no cough or spitting of blood. The 
wounds on the back and arm were wide open, their margins slightly swollen. On 
the 27th, the discharge from the wounds decreased and the sloughs came off, 
preseuting healthy granulation. The difficulty of deglutition and plionation dis- 
appeared. On the 30th, he was removed to Ivure Naval Hospital; when the lace- 
rated wound of the right arm was slightly discharging pus, while the wound of the 
neck was much contracted. The wound of the back was however still wide open, 
though the granulation was favourable, and a new epidermis had developed. On 
iber 8th, the communication between the two wounds under the skin of the 
bark was filled with granulation. On November 9th, the wound on the neck was 
healed by scabbing. However, those of the back and arm discharged rather 
copiously with dull granulation, so the nitrate of silver was applied to the granula- 
tion and iodoform gauze applied. On December 22nd, the wound over the scapula 
1 healthy granulation, and contracted, while that of the arm had still 
unfavourable granulation. On January 1st 1895, the wound of the arm had healed; 
and that of the back had formed cicatrix, leaving only a granulating surface, 3 cm. 
long, in the middle of the back, to which boracic ointment was applied, tili at last 
it healed by cicatrix on January 25th. The patient left the hospital on l'cbru- 
arj -"ill. 

B WOUNDS OF THE THOKACTC CAVITY. 

1 1- -Penetrating wound of left side of chest with blind wound of left 
letf ; — T. Hondo, need 2 1. one of tic crew to No. 3 7.5 cm. gun of the Pus5, in the 
naval i ;agi ment of the fellow sea, was firing on the enemy's ships from the Ntur- 



INJURIES OF THE CHEST AND BACK. 113 

board fort of the upper waist-deck, when a hostile shell burst against an iron pillar 
on the said deck, some of the shell fragments and broken iron pieces, wounding him 
on the left side of the chest and the left ankle joint. On examination, the 5th and 6th 
ribs along the left axillary line were found to be broken, the wound penetrating into the 
thoracic cavity and bleeding profusely. An iron piece penetrated through the outer 
side of the left ankle into the joint, making a blind wound ; moreover, another 
piece was inserted in the back of the middle of the left leg. The injured man was 
pale, with a very weak and intermittent pulse, and complained of acute pain in the 
chest. The foreign body in the wound of the ankle was extrasted ; both wounds were 
antiseptic-ally dressed, and the patient was kept in strict rest. On the 18th, the tem- 
perature indicated 38 3 C. An accumulation of blood in the pleural cavity was evacuated 
and the cavity examined, but no foreign body could be found. The lungs escaped injury, 
and there was no hsemoptysis. The patient however succumbed from collapse at 8 a.m. 

144.— Penetrating wound of the chest with blind wound of left thigh : 

— U. Tsushhni, aged 35, gunner to No. 6 Hotehkiss gun of the Akitsushima, in the 
battle of the Yellow sea, sustained a penetrating wound on the back, and a blind 
one on the thigh from the fragments of a shell which exploded against the shield of 
starboard No. 5 side-gun on the waist deck. On examination, a contused wound, 5 cm. 
long and 2.5 cm. wide, was found running from the right side of the 6th dorsal 
spinous process to the left and upward, reaching deep into the thoracic cavity ; break- 
ing in its course a rib in the infra-scapular region. On breathing or moving his 
body, an intense pain was felt in the left hypochondriac region, and respiration was em- 
barrassed. The margin of the wound gave a sensation as if a mass of snow was being 
pressed on it ; blood mixed with air-bubbles escaped from the wound, indicating injury 
of the lung. On the upper part of the outer side of the left thigh a vertical lacerated 
wound 3 cm. deep was found and a fragment of shell inserted in it was extracted. 
The wounds were antiseptically treated, and the patient kept at strict rest ; he could 
not sleep that night for the constant anguish over the proecordial region as well as the 
actual pain in the chest. On the 18th, the temperature indicated 38'C, and 
coughing was frequent; a dose of morphine given; urine withdrawn by catheter 
On the 19th, the patient was taken on board a transport, and sent to Sasebo Naval 
Hospital on the 21st. At the time, coughing was frequent, with bloody expectoration 
and acute pain in the left side of chest ; there was also a subcutaneous emphysema, 
extending from the left scapular region to the axilla, which, on percussion, was foil n 



114 INJURIES OF THE f'HEST AND BACK. 

to present a slight dnlness at its lower part. The chest was kept at rest with a tight 
bandage, and an antispasmodic mixture internally given. On the "27th, the sub- 
cutaneous emphysema had greatly suhsided ; coughing became less frequent, and the 
bloody expectoration also diminished. On October 2nd, granulation rilled up the 
wound and the discharge lessened ; the subcutaneous emphysema entirely disappear- 
ed ; coughing now became very slight, and no more traces of blood were found in the 
expectoration. On the 17th, the wound became contracted, and on November 20th, 
was completely healed. The wound of the left thigh healed by scabbing soon after 
admission to the hospital. 

lio— Perforated wound of the chest and abdomen :— S. Snyehiro, aged 

31, gunner to No. 4 gun of the Hiyei, in the battle of the Yellow sea, was firing No. 
4 gun on the port side, when a hostile shell burst against the stanchion of the port 
booms. A fragment of the shell inflicted a mortal wound which pierced through the 
left side of the thoracic cavity, breaking the ribs in its course, and passing out on 
he right side of abdomen. He died immediately from the great loss of blood. 

Hi!.— Perforated wound of the thorax :— S. Nishida, aged 44, warrant 

officer of the Banjo. While he was firing on the enemy's vessels in the harbour of 
Wei-hai-wei from the occupied fort of Lu'chotsai, on February 3rd, 1895, a bomb-shell 
discharged from the enemy's ship Laiyuen, exploded in front of that fort. One of the 
fragments pierc d the front of left side of chest and passed out on the right side of the 
back, breaking the ribs in its course and injuring the thoracic viscera; with copious 
bleeding. Death was instantaneous. 

147. — H. Minatsu, aged 22, stoker of the Itsukushima, was wounded in the chest 
at the battle of the Yellow sea, by a fragment of a shell that pierced through the 
port netting in the fore part and exploded when he was on the grating at the upper- 
most part of the fore boiler room. The fragment crushed through the 3rd rib in front 
of the right side of the chest and passed out by the back on the left side, thus causing 
a largo perforated wound. In consequence of an excessive loss of blood, the injured 
man expired on the spot. 

1 1 s —Perforated wound of the thorax with burns of head and face :— H. 

Kikuchi, aged 27, a torpedo-man on board the Itsukushima, in the battle of the Yellow 
sea, was in the torpedo-chamber of the fore part, when a hostile shell exploded against 
the torpedo-net boom breaking the ship's side. The fragments dashed into the chamber 
and inflicted a perforated wound on his thorax, piercing through the front of the left 



[NJURIES OF THE CHEST AND BACK. 115 

side of the chest, breaking the 4th rib anil passing out by the back. Burns of the head 
and face were also sustained. He died on the spot. 

149.— Perforated wound of the thorax and upper arm :— K. Yanagi- 
wara, aged 30, senior blacksmith of the Itsukushima, in the battle of the Yellow sea, 
was in the fore torpedo-chamber, when an enemy's shell exploded against the 
torpedo-net boom and crushed the ship's side. The fragment of shell entered the 
torpedo-chamber and indicted a large perforated wound of the chest, piercing the 
front of the rigl it side of the chest wall, breaking ribs and finding an exit at the 
back. There was another perforated wound in the middle of the left upper arm ; 
excessive bleeding occurred from both wounds, yet his mind was very firm. When 
a nurse came to his assistance, the injured man took out from his pocket the key 
of his tool-drawer and said : — " This is an important key and if this be not found 
after my death, it will cause great trouble, so please deliver this to the officer in 
charge.'' No sooner had he said this than he lost consciousness and expired ! 

150.— Perforated wound of the thorax, and left thigh with burns 
of face and neck: — &• Yamaguchi, aged 24, one of the crew of the fore torpedo 
on board the Itsukushima, in the battle of the Yellow sea, was in the fore torpedo- 
chamber, when a hostile shell exploded against the torpedo-net boom and crushed 
the ship's side. Some of the shell-fragments that entered the torpedo-chamber 
inflicted on him a perforated wound in the left side of the chest, also another one 
in the middle of the left thigh, with burns on the face and neck. He died on 
the spot. 

151.— Perforated wound of thorax with fracture of dorsal vertebrae: 

— K. Nisbimura, aged 33, petty officer on board the Amagi, in the bombardment 
of Wei-hai-wei, while firing on the enemy's vessels in the harbor from the occupied 
fort of Lnchotsai, on February 3rd, 1895, was wounded by one of the fragments 
of a bomb discharged from the Saiyneu. The missile entered by his back and found 
exit in the front of the chest thus inflicting a perforated wound; the dorsa] 
vertehne were broken and the lungs severed. lie died on the spot. 

152.— Mutilation of thoracic wall and lower limbs with burns of 
whole body : — J- Inouye, aged 27, crew of the port search-light of the Matsushima, 
during the battle of Yellow sea, was engaged in temporarily repairing the electric 
firing apparatus on the fort in the fore part of the lower deck, when a hostile 
shell exploded against the shield of No. 4 side-gun on the port side of the same 



]]g INJURIES OF THE CHEST AND BACK. 

deck and ignited the ammunition provided for the side-gun. By some of the 
fragments and by the explosion of the ammunition his chest wall was mutilated 
and the lower extremities crushed with burns of his whole body, causing instant 
death. 

153. — A. Takenaka, aged 21, crew of the No. 4 gun of the Hiyei, in the engage- 
ment of the Yellow sea, was standing with the powder-case hung about his chest by 
the No. 4 gun on the port side of the waist-deck, when a hostile shell came flying over 
the netting of the starboard waist, and burst against the stanchion of port booms. One 
of the fragments hit the powder case and exploded the ammunition in it, thus his chest 
wall and the thoracic viscera were crushed and the lower extremities mutilated and 
the whole body burnt. He died instantaneously. 

154.— Mutilation of thoracico-abdominal region and lacerated wound 

of right thigh : — S. Sunagawa, aged 30, crew of No. 4 gun of the Hiyei, in the battle 
of the Yellow sea, was firing on the fort of the gun on the port side of the waist-deck, 
when a hostile shell came flying over the starboard waist netting, and exploded against 
the stanchion of the port booms. By one of the fragments, he was injured with a deep 
lacerated wound on the inner side of the lower third of the right thigh, complicated 
with an injury to the femoral artery. Bleeding was stopped immediately by one of 
the ambulancemen who compressed the artery and conveyed the wounded man to 
the surgery in the ward-room in the after part of the lower deck. During the 
surgical operation, another shell exploded in the room, by some large fragments 
of which the chest and abdomen were smashed, the thoracic as well as the abdominal 
viscera; being torn to pieces. He died on the spot. 

155.— Mutilation of the chest and abdomen:— S. Imabara, aged 31, craw 
of the port 9-pounder of the Tstikushi, in the bombardment of Zhih Island on February 
3rd, 1895, was standing on the left side of the funnel on the upper deck, when a hostile 
shell hit his trunk, mutilating the chest and abdominal walls together with the organs 
inside. Death was instantaneous. 

6 -INJURIES OF THE ABDOMINAL AND LUMBAR REGIONS. 

(A). [NJUEIES OF THE ABDOMINAL WALLS. 

150. — Contusion of abdomen : — S. Tanaka, aged 20, crew of No. 5 Q.F. gun of 

the Akagi, in the battle of the Yellow sea, was wounded on the right side of the abdo- 
men by a fragment of a shell that came living by the stern, while he was tiring on 



INJURIES OF THE ABDOMINAL AND LUMBAU REGIONS. ]]y 

the starboard side in the rear of the upper deck. On examination, there was an abrasion 
in front of the right anterior superior iliac spine bat no injury to the abdominal 
viscera?. Carbolic dressing was applied. On the 30th of the same month the abrasion 
healed by scabbing. 

157.— Contusion of right lumbar region :— K. Matsunaga, aged 24, crew of 
No. 9 gun of the Hiyei, in the engagement of the Yellow sea, was firing on the fort of 
the gnu at the stern, when a hostile shell pierced through the upper part of the port on 
the starboard side of the stern. From the splinters of wood he sustained contusion on 
the upper part of the crest of the right ilium. Spirit of camphor was applied and the 
wound was healed on the 19th of the same month. 

158— Contusion of left lumbar region:— S. Nagaoka, aged 84, petty officer 
on board the Hiyei, was handling the rudder by the wheel on the quarter-deck, in the 
battle of the Yellow sea, when au enormous shell exploded in the ward-room at the 
rear of the lower deck. He was thrown down, and in falling sustained small contused 
wounds over the left lumbar and sacral regions. Iodoform was sprinkled and 
adhesive plaster applied. On the 21st following, the wounds were healed. 

159.— Lacerated wound of the right lumbar region :—R. Ishii, aged 24, 

Assistant Navigating Officer of the Matsushima, during the bombardment of the eastern 
fort of Lieukung Island, on February 7th, 1895, was engaged in measuring distances 
on the fore bridge ; when a hostile shell flying over the bridge inflicted a lacerated 
wound midway between the right iliac crest and the costal arch, 15 cm. in length 
and 9 cm. in width. The skin, subcutaneous tissue and superficial layer of the muscles 
were scraped away ; exposing the muscles at the bottom of the wound ; the margins 
were of au irregular shape and from the posterior half of the upper margin hung a 
flap C cm. long and 5 cm. wide ; while all around the wound were the black marks 
of burnt powder. The bleeding and pain were not severe ; no injury of the abdominal 
viscerre was to be seen. The wound was cleansed with carbolic lotion ; the flap 
arranged to cover the wound and sublimate gauze applied. On the 8th, he was 
transferred to the hospital-ship Kobe-maru. In a few days, the wound suppurated; 
the flap and margins of the wound presented gangrenous conditions, which had to be 
scraped off. On the 14th, granulation gradually developed and the wound became 
even and clean. On the 20th, he was admitted to the Sasebo Naval Hospital. At 
the time, au oval granulating wound was present on the right lumbar region extending, 
above, one inch below tlu costal arch ; below, about three and a half inches above the 



US INJURIES OF THE ABDOMINAL AND LUMBAR REGIONS. 

great trochanter of the feimir ; in front, about half an inch above the anterior superior 
iliac spine ; behind, to within two inches from the lumbar vertebra?. The vertical dia- 
meter was 10 cm. and the antero-posterior diameter 15 cm. ; the bottom was exposing 
muscles and dotted lure and there with pustular spots. On the 25th, the granulation 
was healthy, but in its anterior portion bled freely. The application of iodoform and 
sublimate gauze was resorted to. The granulation afterwards developed so as to fill 
the wound, yet the growth of epidermis was very slow. On April 12th, the granu- 
lation presented trauverse diameter 14 cm., and longitudinal 10 cm.; three small 
pii ces of -km were grafted there. On the 16th, the dressing was renewed, when the 
skin grafts appeared to be growing ; but subsequent suppuration of the granulating 
surface prevented their growth. On May 11th, the granulation became healthy 
and the discharge decreased : three pieces of skin grafts were again tried with 
aseptic precautious. After that the epidermis spread gradually. On June 10th, the 
temperature rose to 38°.4 C. with slight chilliness. On examination, the wound was 
found to have a slight discharge of pus. and the granulation to have in two places 
yellow patch's of the size of a 2 sen copper, speckled with black here and there. When 
the patches were scraped and examined with a microscope, they showed countless 
streptococci, but the margin of the wound exhibited no signs of inflammation or 
suppuration. So 10 per cent carbolic lotion was applied to the patches and a weaker 
lotion of carbolic compress applied over the granulation. On the 11th, the tempera- 
ture tell to normal : though the colony of streptococci were somewhat extended, yet 
the coloured patches had diminished a little. On the 14th. the colony entirely 
disappeared hut on the 19th, the surface was again covered, one-third of it being 
i ed with copious pus discharge. The use of 10 per cent carbolic lotion 
was again resorted to. After the 21th. the granulation resumed a healthy state, and 
on July 12th four beau-sized pieces of skin were grafted. All these grafts took well 
and on the 20th August the whole surface was covered with skin. The injured 
officer lift the hospital on the 23rd. 

160.— Concussion of spine and sprain of ankle joints ;— u. Kawamnra, 
.< , L> Surgeon hi chief of the Standing Squadron of the flagship Matsushima, in 
tie battle of the Yellow Sea, on September 17th. 1894, was attending wounded ct 
m the surgery on the fore pari of the upper deck, when a 30.5 cm. shell expl 

-• the Liield of No. 4 side-gun on the port side of the fore part of the lower di 
al the same time igniting the ammunition provided for the side-gun. By the shock 



INJURIES OF THE ABDOMINAL AND LCMBAU REGIONS. H9 

of the explosion, the upper deck was tilted and torn up just where he was standing, 
causing concussion of the lumbar vertebra? and sprain of the ankle joints. There wa s 
an intense pain at these parts and paresis of the lower extremities so as to prevent 
his standing while he was being carried to the cabin : frequent attacks of spasm-; 
occurred with extreme pain in the loins. Swelling and intense pain of the ankle 
joints and feet, with constricting sensation around the abdomen, and slight numbness 
of both lower limbs, appeared toward the night of the accident. On the 21st, he was 
admitted to Sasebo Xaval Hospital. At that time, the temperature was 38 3 C. ; pulse 
7S : the tongue furred ; appetite impaired, attended with nausea : yet the thoracic and 
abdominal viscerse were sound. On examination, hyperesthesia over the -ith lumbar 
vertebra and lumbo-sacral joint was found. On the "23rd, the temperature indicated 
38° C, pulse 76 ; the nausea still continued and the appetite was not restored yet ; the 
swelling of ankle joints decreased a little yet the pain did not subside at all. Urine 
was cloudy, and on examination no abnormal constituents were found. On the 26th 
the temperature stood at 37. °6 C; the nausea had subsided ; the coustricting sensation 
had disappeared in the abdominal region, also hyperesthesia of the lumbar region 
subsided. The swelling of the right ankle was diminishing by degrees, while the swel- 
ling of the left side had undergone no remarkable change. On the 30th, the sensation 
of both extremities was found restored to its normal state as regards the sense of touch, 
but analgesia p rsisi 1 so that no pain was felt if the skin was pinched. The sen- 
sation of warmth over the spinal cord being tested, the sensation of cold was normal but 
that of warmth was very acute over the 3rd and -1th lumbar vertebrae. On the 4th of 
October, the temperature still stood at 37. o' C; the swelling of the ankle joints 
subsided remarkably so as to produce wrinkles in the skin in those parts — especially 
on the right side. By this time, the calves became slightly emaciated, and the tendon 
reflex of the knee increased. By the 18th, the analgesia of the lower extremities had 
greatly subsided: the patellar reflex likewise was lessened, and the swelling of the 
ankles greatly decreased. Walking was first tried on this day, but it proved a failure 
owing to the pain felt at the ankle joiuts whenever they were moved. On the 26th, 
temperature became normal, the swelling of the right ankle completely disappeared, 
only a slight swelling of the left ankle still remained: squatting on the bed and bend- 
ing the body caused a sensation of pressure over the 3rd lumbar vertebra. When he 
tried to walk pain was felt in the soles of the feet. On November 10th, all symptoms 
were relieved : walking in the room still caused the sensation of pressure over the 



120 INJURIES OF THE ABDOMINAL AND LUMBAR REGIONS 

3rd lumbar vertebra and the pain in the deep part of the left ankle. After this time, 
progress was favourable and he could walk about 30 yards. However, <>n the night of 
Decamber 8th, a pain was felt at the loins, and on the next morning an oval swelling 
6 cm. in vertical diameter and 4.5 cm. in transverse diameter appeared on the right 
side of the 3rd lumbar vertebra, but with no inflammatory symptoms. To the touch, the 
swelling proved to be uniformly hard with tenderness on hard pressure, and a dull pain 
was elicited in the movements of body. On the 25th, the swelling around the left ankle 
still lingered, a thickening just below the outer malleolus remained and pain of the joint 
was caused by the eversion or inversion of foot, showing that the power of walking had 
not yet been restored to its normal condition. In this condition he left the hospital on 
the 30th. The walking power was subsequently nearly restored to its normal state. 

I. . PEKFOEATED WOUND OF ABDOMINAL CAVITY. 

101.— Penetrating wound of the right side of chast and abdomen, 
blind wound of left leg and contused wound of head and left forearm :— 
I. Sasauuki, aged 40, quarter-mister of the Saikyo-maru, in the battle of the Yellow 
s ea, September 17th, was standing by the telegraph on the aft uppermost deck to send 
an order to the rudder, when a hostile shell hit the last boat davit on the starboard 
quarter. He was wounded by some of the fragments on the head, chest, upper and 
lower extremities. On examination, there were found (1) a valvular wound 8 cm. 
in length running transversely over the right temporo-parietal suture; the margins 
irregular, the depth C cm. downwards perforating the occipito-frontalis and abrasing 
the periosteum yet without fracture of the bone ; (2) at the right !>th intercostal 
space, a lacerated wound 3 cm. long running obliquely backward and downward ex- 
tending from the anterior to the posterior axillary lines; the margins irregularly turn, 
the 10th rib broken, losing some 1.5 c m. of bone substance, and the bottom of the 
wound apparently perforating the liver ; (31 a small shallow contused wound on the 
front aspect of the middle of the left fore-arm ; (I) a lacerated wound 2 cm. long on 
the inner side of the lower third of the left leg ; the margins were ragged, the depth 
reaching as far as under the skin of the opposite side, where the presence of a BOlid 
substance was recognized ; a counter-opening was made and a fragment of shell, of 
an irregular-shape, 2.4 cm. in vertical diameter, 2 cm. in transverse diameter, and 
1 cm. in thickness was extracted. A piece of cloth was adhering to the fragment 
(see the illustration No. 5). 



—I 33- 

?3 S 



5 § 



33 52 
J> — I 



5> 




... % \l 






INJURIES OP THE ABDOMINAL AND LUMBAR REGIONS. 121 

All the wounds were antiseptieally treated, and to the per- 
forating wound of the leg a drainage tube was introduced. 
On the ISth, the temperature was normal ; witli no bad 
signs except slight pains about the wounds. On the 19th, 

he was transferred on board a transport, and admitted to 
Fig. 5 Shell fragment ex- . . . 

tracted from the left le^ Sasebo Naval Hospital on the 21st. On admission, the 

(cloth adhering) . , . -, » . , t i 

wound on the right side of the chest was discharging a 

yellowish thin fluid and the patient complained of pains in the chest and coughing. 
The broken ends of the rib were sharp and irregular ; the bottom of the wound reached 
deep into the liver preventing thorough examination. The sharp ends of the rib were 
pared off. All the other wounds progressed favourably. On the 23rd, the dressing of 
the chest wound was changed; when the bile came out from the wound, which presented 
a darkreddish colour. The wound of the leg also discharged a little pus, but those of 
the head and of the fore arm speedily developed granulation. On the 27th, by probing 
into the chest wound, a piece of bone flat and rough, of the size of a bean, was extracted. 
Flie peritoneal covering of the liver was abrased and a part of the liver substance 
injured. The wound was washed with a carbolic solution, and an iodoform gauze 
applied. The temperature rose a little. On October 1st., some of the decayed covering 
and liver substance came out of the wound. The wound was cleansed and an anti- 
septic iir issing tightly applied. On the 2nd, an oval elevation of skin was found on 
the right side between the first and second lumbar vertebrae, which moved to the 
touch and gave a sensation of some solid substance. The part was opened with an- 
tiseptic precaution and a fragment of shell, of an irregular rectangular shape, about 
the size of a bean was extracted. As regards its course, whether the fragment had 
entered by the chest wound or had taken a different course by passing round the ribs, 
cuold not be asoert lin 1 1. The incision was healed on the Oth. On the 7th, the disch- 
arge from the chest wound was the same as before, dec lyed liver substance came out 
mixed with bile emitting a peculiar smell somewhat like peptone. In the right iufra- 
scapular region, dulness en percussion and a slight friction was revealed, accompanied 
with cough ; the patient became anaemic and debilitated. A mixture of iron and 
quinine was internally given. On the loth, the discharge from the chest wound greatly 
; : two pieces of sloughs were taken out. The perforating wound of the leg 
became narrowed by the granulation, so the drainage tnbe was replaced by a strip of 
sublimate gauze. With the wounds of head and fore-arm, the pus discharge ceased, 



1-2-2 INJURIES OF THE ABDOMINAL AND LUMBAR REGIONS. 

and the granulation surface became contracted ; the temperature rose slightly during 
the night. On the 27th, the wound of the forearm cicatrized ; that of the chest 
developed granulation so that the part became clean and contracted, and no longer 
discharged sloughed hepatic substance ; a slight discharge of pus and bile, however 
still continued. On the 2nd of November, the chest wound still discharged bile, though 
all the other conditions were favourable. The friction sound completely disappeared, 
but the dulness persisted over the infra-scapular region. On the loth, the tempera- 
ture suddenly rose to 89° C; on examining the wound of the chest a dead piece of bone 
the size of a pea and a slough of liver, plugging the orifice and preventing the escape of 
pus, were observed. These were removed and 15 gramme of a greenish pus evacuated 
The nest morning the temperature fell to normal, and the discharge ceased gradually 
The wound of the head contracted to the size of a 5 rin copper and the pus discharge 
entirely ceased. On the 2nd of December, the wound of the leg was completely 
healed, and that of the head had contracted to the size of a beau, while that of the 
chest reached to a depth of 3 cm.; but the discharge was nearly stopped and granula- 
tion was healthy. On the 20th, the chest wound formed a cicatrix, and the head 
wound healed by scabbing on January 7th, 1895. On the 11th, he had so completl 1 '■ 
recovered as to be able to rejoin the ship. (See the illustration.) 

K'"-.— Penetrating wound of the left side of chest and abdomen with 
perforated wound of left arm : — S. Ito, aged 21, seaman of the Saikyo-maru, in 
the battle of the Yellow sea, on September 17th, 1894, was tiring the 57 m.m. Q.F. 
gun in the rear of the uppermost deck, wheu a hostile shell exploded against the 
aftermost boat davit on the starboard quarter ; some of the fragments wounded the 
left side of his chest and left arm. On examination, a lacerated wound 3 cm. long 
was found over the 8th rib on the left axillary line ; the margins were ragged and 
widely open ; the wound took a course forward and downward, breaking the 10th rib, 
and penetrated into the thoracic cavity. Another perforating wound was seen just 
above the left elbow joint passing from the outer side of the upper ami to its inner 
side. Tie opening of the wound on the outer side was of an irregular form, measuring 
6 cm. \ ertically, and -1 cm. laterally ; while the exit on the inner side was 2.7 cm. lo 
and opened irregularly ; but the humerus was intact, and no hea\y bleeding occurred. 
as the brachial artery had escaped injury. After antiseptic dressing, the man was 
ordered to have stricl rest. On the 18th, pain was felt in the lower part of the abdo- 
men, and the temperature rose to ISS 3 C. The dressing was changed, and a solution of 



INJURIES OF THE ABDOMINAL AND LUMBAR REGIONS. 123 

morphine injected subcutaneous]}' ; and cold applied to the abdomen. On the 19th, 
he was sent by a transport to the Sasebo Naval Hospital. On the way, the symptoms 
aggravated, abdominal pain becoming intense, temperature rose to 39 3 C; pulse 
105. In the night nausea and vomiting ensued, showing characteristic signs of peri- 
tonitis. The dressing was changed again. The chest wound was slightly inflamed. 
An opiate was given internally, and cold constantly applied to the abdomen. On the 
21st, ho was admitted to the hospital. Symptoms at the time ; expression pale and 
full of anguish, nutrition of the body impaired, respirations uneasy ; slight cough ; 
sputa mixed with blood ; abdomen tympanitic, yet the temperature not exceeding 
37°. S C. On the 22nd ; the temperature stood at 37". 4 C, pulse 78, respiration 18 
to 24 per minute ; there was no remarkable change of symptoms. On the 23rd 
symptoms aggravated : — -the temperature rose to 39°.6 C, limbs cold, pulse weak, 
numbering 120, respiration laborious, tympanites ; and pains in the chest and abdo- 
men increased so that extreme uneasiness was complained of. The dressing was 
changed, and an enema of turpentine, yolk of egg and gum mucilage was injected. 
On the 24th, the pain of the chest steadily increased, attended with a slight hsemo- 
sptysis. Sloughs around the lacerated margin of the chest wound discharged pus, and 
gas in the abdomen increased steadily, so that the chest and abdomen were intensely 
distended, ami the patient was in a state of constant anguish and groaning. 
Temperature 38°.6 C, pulse 92 ; the enema of turpentine was repeated and applica- 
tion of ice to the chest and abdomen continued. Laparotomy was hopeless, as the 
condition of the patient at the time of admission was so low. On the 25th, the ther- 
mometer stood as the day before ; pulse 100, exhaustion increasing day by day. Egg 
and brandy was given at frequent intervals. On the 20th, a large quantity of blood 
was passed through the bowels ; the symptoms were perilously aggravated, the 
patient collapsed, and the temperature indicated 39°. 4 C. On the 27th, the tempera- 
ture indicated SS^.G C; vomiting had occurred frequently since the previous day, and 
much bile had been brought up ; pulse became rapid and thready, and the pain in the 
abdomen excruciating ; the patient was constantly crying and groaning. Thus, in 
spite of all efforts to alleviate his distress, he succumbed at 8.30 p.m. 

163.— Penetrating wound of abdomen with burns of face, hands and 
feet : — Y. Ogawa, aged 24, a bandsman on board the Matsushima, in the battle of the 
Yellow sea, September 17th, 1894, was passing the fore-part of the lower deck on duty 
as a carrier of the wounded, when a 30.3 cm. hostile shell burst against the shield of 



124 INJURIES OF THE ABDOMINAL AXD LUMBAR REGIONS. 

the port No. 4 gun in the fore-part of the lower deck, and ignited at the same time the 
ammunition provided for the side-gun. He sustained burns of the first degree on the 
face, and on the dorsa of both hands and feet ; also one of the fragments of shell inflict- 
ed a penetrating wound on the left abdominal region. On the 20th, he was admitted 
to ;iie Sasebo Naval Hospital, at which time, the burned parts presented a dark reddish 
colour. The wound of the abdomen was of a round shape, the size of one yen silver, 
at a spot 7 cm. to the left and below the umbilicus : in the middle of wound another 
small hole penetrating to the abdominal cavity was noticed. Symptoms of peritonitis 
had already set in, as the tension and severe pain of the abdomen, nausea and vomit- 
ing had for some time been going on. Antiseptic measures were taken for the wound, 
application of ice to the abdomen and internal administration of anodyc sort- 

ed to. On the 25tb, the burns healed ; and the peritonize signs slightly abated. 
But exhaustion increased gradually and at last he died on the 28th of October. 

k;4. —Penetrating wound of abdomen with blind wound of the left 
thigh : — Y. Matsumoto, aged 24 if the Itsukushima, in the engagement of the 

Yellow sea, was working in the after boiler room, when a shell pierced through the 
starboard coal bunker in the waist and exploded against the ladder in the boiler- 
room. One of the fragments of shell inflicted a penetrating wound in the middle of 
the abdomen ; another one, a small blind wound in the left thigh. The injured man 
died on the spot before assistance was given. 

i' ; "'-— Penetrating wound of abdomen with fractures of the humerus, 
thigh and le°' : — K. Kimura, aged 24, stoker of the Itsukushima, during the engage- 
ment of the Yellow sea, was on the highest grating of the fore boiler-room, when a 
shell exploded, after piercing through the p fore part : the fragments 

of shell inflicted the following wounds : a penetrating wound of the abdom 

umbilicus, the size oi a two sen copper, from which the bowels came out: and 
pound fractures in the middle of the right upper arm in the lower ['art of the 
left thigh and on the left leg. The injured nam died instantly from the sh 
166.— Penetrating wound of abdomen with fracture of the ilium: 

K. Narabara, aged 86, petty officer on board the Itsukushima, during the battle of 
the Yellow sea, was in I lo-chamber in the fore-part, when a hostile shell ex- 

| 'liking tin outer side. The fragments breaking 

through the ship's si. I- dashed into the torpedo-chamber, where one of them gave him 
a penetrating wouud ou ■ ;ion, from which the intestines i and 



INJURIES OF THE ABDOMINAL AND LUMBAR EEGIOX3. 125 

a portion of the anterior superior spine was broken. Thus the injured man diad on 
the spot, owing to the great loss of blood, and shock. 

167.— Penetrating wound of sacro-iliac joint :— J- Umimiehi, aged 21, 
a seaman of the Hiyei, in the battle of the Yellow sea. was stationed at the relieving 
tackle in the cabin on the after-part of the lower deck, when an enormous shell 
exploded in the ward-room. The fragments scattered about, greatly damaging the cabin, 
and one of the wooden splinters wedged itself into the man's sacro-iliac joint. As all 
the surgeons on board were killed at that very moment, he had simply to be dressed 
by one of the crew, until the proper treatment was given by the surgeons from the 
other ships, when the ship arrived next morning at the naval station near Cape 
Choppeki. On examination, a wooden splinter was found wedged in between the 
left sacro-iliac joint, the entrance wound measured 5 cm. long and 3 cm. wide; and 
the margins were lacerated. On trying to extract the | ps it was 

found no easy matter ; so after the application of an antiseptic dressing, the patient 
was ordered to keep rest. Soon after the injury, paraplegia of the lower extremities 
and incontinence of mine followed. On the 19th, he was removed to a transport to 
be transferred to the Sasebo Naval Hospital. On admission, the wound dischai 
Copiously ; both the sacrum and ilium being broken at the joint, presented the shape 
of ragged rocks ; pain extreme at the slightest movement of the body ; mine pa 
incontinently. On the 22nd, under chloroform, the wound was slightly widened and 
the wooden splinter wedged into the joint extra ■■ !l iwever, the pie: 

tightly inserted that only a part of it and some broken pie;es of bone were extracted, 
and that only by main force. On probing the bottom of the wound farther, it was 
found that the rest of the splinters, by forcing itself into the joint had reached the 
pelvic cavity. At this point the operation was . for the day, and the wound 

cleansed by an antiseptic solution ; the temperature indicated 39°. 2C. in the night ; 
evacuations passed unconsciously, and the urine contained blood. Copious discharg- 
es from the wound frequently soiled the dressing. On the 25th, the remaining 
piece of wood was extracted under chloroform ; and the bladder washed out by a 
solution of boracic acid. Every effort was made to keep of the patient's strength 
both by food and tonics, and from that time, the temperature ranged between 38' and 
89 ; C. The discharge from the wound was profuse : urine mixed with blood and 
pus passed involuntarily, so that the exhaustion aggravating day by day, the patient 
at last died on the 10th of October. 



126 INJURIES OF THE ABDOMINAL AXD LUMIIUI REGHOXS. 

1GS. — Perforating wound of abdomen : — S. Nakano, aged 39, Lieutenant 
Commander of the Tenryii, during the bombardment of Linkiing Island on February 
lltb, 1895, was standing on the commanding tower on the starboard side of the 
bridge, when a hostile shell exploded, striking the No. 2 port gun at the middle of 
the upper deck; by one of the fragm ints of sh< il that flew up to the bridge, he was 
pierced through the abdomen .nil thrown overb iard : death was instantaneous. 

169. — R. Nagata, aged 28, Lieutenant of the Akitsushima, in the battle. 
Yellow sea, was commanding the port battery, standing by No. G side-gun on the 
port side of the waist-deck, v. i hostile shell exploded, hitting the shield of No. 5 

side-gun on the starboard ; by some of the fragments of shell, he was pierced through 
from the abdomen to the loins, and in consequence of a profuse [Hemorrhage and 
of th< spired on the spot. 

170. — M. Shida, ag 28 gunner of X p. •" side-gun of I ishima, in the 

battle of the Yellow sea, was tiring No. 5 side-gun on the starboard of the waist- 
deck, when a hostile shell exploded against the shield of that gun. One of the broken 
shell-fragment, inflicted a perforating wound in his abdomen, and lie died on the 
ving to heavy hsemorrkage and the shook. 

171.— Perforating wound of lumbar region: — T. Hasbiguchi, aged 21. 
Midshipman of the Akagi, in the battle of the Yellow sea, was on the fore top 
measuring the distances of the h when a -hell from the enemy piei 

him from the loin to the abdomen, breaking the linn' bras an 1 pelvis. Owing 

to the great hfemorrhas I by the rupture of the abdominal aorta, he died on 

the spot. 

172.— Perforating wound of the lumbar region with blind wound on 
the back ;— -M. Mnmabucbi, aged 26, a carpenter of the Akagi. in the batl 
Yellow sea, was stationed as a tire-brigademan on the fore-part of the lower deck, 
when a hostile shell exploded on that deck. One of the fragments inflicted number- 
wounds in the bade, and a perforating wound in the loins, with the fracture of 
the lumbar vertebra^, causing a heavy h emorrhage. He was kill. 1 on the -pot. 

173. Perforating wound of the lumbar region with lacarated wound 

of the leg: — K. Fukuhara, aged 24 the crew of No. 1 short 7 .'< cm. 

gun of the Fnso, in the course of tie- bombardment of Zbib Island February 7th, 

1895, was standing by the sidi of No 1 7." cm. gun in the fore part of the upper 

. when a liosl d through the starboard sill ol the gallant-forecn 



INJURIES OF THE ABDOMIXAL AND LUMBAR REGIONS. 127 

and burst in the fore part. One of the broken pieces inflicted a perforating wound 
passing from tbe left loin to tbe right inguinal region, breaking tbe ilium iu its course, 
and found its way out to a spot above tbe right Ponpart ligament. From tbe exit a 
portion of lacerated intestine protruded. Several pieces of broken bone, were found 
in the wound, of which one — ■ a fragment of the crest of ilium — was not less than 9 
cm. in length. Farther, in the middle of tbe outer side of the left leg, there was a 
lacerated wound, but without any lesion of the bone. Besides the wound of the 
intestines just mentioned several other parts were found to bo wounded ; to suture 
all of them would have taken much time to the neglect of other patients, so the 
intestines were, for the present, cleansed and returned to their proper place, until 
the time could be given for proper treatment. The wound of the abdominal walls 
was also simply cleansi i with an application of antiseptic dressing, and then strict 
rest was ordered. The mind of the patient haviug had no change at all from the 
beginning of the wound, conversation was as sound as usual ; to alleviate the constant 
and intense pains in the abdomen, morphine was repeatedly injected. There was 
also a desire to pass urine but without effect : so a catheter was introduced but only 
blood came out. It was thus evident that tbe bladder was injured too. At 4 
o'clock in the afternoon, that is, eight hours after the wounds, be died of collapse. 

174.— Perforating wound of lumbar region with compound fracture of 
the right thigh : — T. IsMkawa, aged 22, a male nurse of the Hiyei. in the battle 
of the Yellow sea, was assisting in an operation on a wounded man in the surgery 
on the rear of the lower deck, when a hostile shell of 30.5 cm. burst against the mizzen 
mast in that place. He sustained a perforating wound from some of the splinters, 
passing from the loins to tbe abdomen and crushing the lumbar verteblse; and a com- 
pound fracture at the middle of the right femur. He died from great haemorrhage 
and shock. 

175.— Mutilation of abdominal wall with compound fracture of right 
thigh : — K. Yoshioka, aged 2G, one of the crew of a torpedo of the Matsushima, in the 
battle of the Yellow sea, was shot through the abdominal wall by a shell that dashed 
into the torpedo room, the abdominal wall being so mutilated that the intestines 
protruded. Besides this, he sustained a compound fracture of the right femur. He 
was instantly taken to the surgery on the fore part of the upper deck (the surgery 
on the lower deck had already been destroyed) and was undergoing an operation, 



]2S INJURIES OF THE ABDOMINAL AND LUMBAR REUIOXS. 

■when another hostile sliell of 30.5 cm. exploded in the fore part of the lower deck 
and gave him a" severe shock which caused instant death. 

176.— Partial mutilation of abdominal region :— J. Ogiwara, aged 22, a 
carpenter of the Takachiho, in the hattle of the Yellow sea, was turning the fan for 
the magazine in the gun-support of the revolving gun in the rear of the lower deck, 
when a hostile shell exploded in the rear of the starboard side. Some fragments of 
the shell pierced the ship's side and dashed into the gun-support, mutilating the left 
side of the abdominal wall. He died on the spot from the shock. 

177. — Mutilation of abdomen : — C. Ishizuka, aged 26, Chief-Paymaster of 
the Hiyei, in the battle of the Yellow sea, was, as an assistant to the surgeons, taking 
the record of the wounded men, seated on a chair in the surgery of the ward-room at 
the rear of the lower deck, when a 30.5 cm. hostile shell entered the room piercing 
through the starboard side of the stern, and burst against the mizzen-mast. One of 
the largo fragments of the shell cut through his bod} - , causing instant death. 

17S. — C. Murakosbi, aged 30, Assistant Surgeon of the Hiyei, in the battle of 
the Yellow sea, was attending on a wounded case in the surgery, when a 30.5 cm. 
hostile shell exploded in the said room. One of the large fragments of the shell 
severed his trunk, causing instant death. 

179. — M. Kono, aged 32, one of the torpedo men of the Matsushima, in the buttle 
of the Yellow sea, was at work in the middle torpedo-room, when a hostile shell 
dashed into the room after piercing through the port side, and shot right through his 
abdomen, causing instant death. 

180. — T. Kitamnra, aged 26, a torpedo-man of the Matsushima, in the battle of 
the Yellow sea, was at work in the middle torpedo-room, when a hostile shell entered 
the room and killed him outright by cutting him in two at the abdomen. 

181. — F. Yubara, aged 26, a torpedo-man of the Itsukushima, in the battle of 
the Yellow sea, was at work in the fore torpedo-chamber, when a hostile sliell exploded 
against the boom for the torpedo net on the starboard side in the fore part. Some of the 
fragments crushed through the ship's side into the torpedo-room and mutilated his ab- 
domen. He was killed instantaneously. 

182. — I. Nakamura, aged 33, petty officer of the Teniyfl, in the course of the 

attack ofWei-hai-wei on February 11th, 1895, was on the starb on the waist of 

the upper deck, when a hostile shell exploded against the gear of No. 2 port-side gun 

of the upper deck. One of the fragments of shell mutilated his trunk from 



INJURIES OF THE ABDOMINAL AND LUMBAR REGIONS. 129 

the right epigastric region obliquely to the fork of the thigh, so that the abdominal 
viscera protruded. He was killed on the spot. 

183. — T. Izawa. aged 2S, a seaman of the Tenryu, in the course of the bombard- 
ment on the eastern fort of Liukuug Island, on February 11th, 1895, was acting as 
a shell-carrier on the starboard side on the waist of the upper deck, when a hostile 
shell exploded against the gear of No. 2 port-sideguu on the waist of the 
upper deck. One of the fragments of shell cut him in two at the epigastric region. 
He was killed outright. 

184. — W. Ono, aged 22. one of the crew of 12 cm. gun of the Tenryu, in the 
course of the attack on tin eastern fort of Liukung Island, on February 11th, 1895, 
was standing on the starboard side on the waist of the upper deck, when a hostile 
shell burst against tin- gear of No. 2 port-side gun. One of the fragments of shell 
mutilated his trunk from the right epigastric region down to the fork of the thigh 
causing the protrusion of the abdominal viscera?. He was thus despatched outright. 

185.— Compound fracture of pelvis and right thigh :— S. Mukunoki, aged 
22, one of the crew of No. 1 gun of the Akagi, in the engagement of the Yellow 
sea, was firing No. 1 Q. F. gun on the starboard side on the bridge, when a shell 
entered by the stern, and burst against the support of the said gun. One of the 
fragments of shell mutilated the right side of pelvis and cut through the right thigh 
together with the femoral artery. He died instantaneously from haemorrhage 

and shock. 

18(5.— Mutilation of the lower half of the hody :— T. Tokunaga, aged 25, 
a torpedo-man of the Matsushima, in the battle of the Yellow sea, was at his 
duty in the middle torpedo-chamber, when a shell dashed into the room through the 
port side and struck him. so that the lower half of his body was completely mutilated, 
causing instant death. 

(The corpse of this man was not found for some time, but afterwards the upper 
half of his body was discovered blown into the store in front of the 32 cm. gun 
mounting behind the middle torpedo-chamber.) 

187. — T. Miyake, aged 39, Chief-Surgeon of the Hiyei, in the battle of the Yellow 
sea, was attending to an injured man in the surgery, | the ward-room at the rear of 
the lower desk) ; when a 30.5 cm. hostile shell dashed into the room piercing 
through the starboard side, and burst against the mizzen-mast. One of the large 



]30 INJURIES OF THE UPPER EXTREMITY. 

fragments of shell severed 1) is trunk from the hypogastric region, so that the lower 
half nf the body was crashed to pieces. Thus he was killed outright. 

(The lower half of the body of the deceased surgeon was so completely blown to 
pieces that nothing could be discovered for some time ; hut afterwards a severed leg 
was found in a corner of the ward-room, which was judged to he his from the shoe 
that was on it.) 

7-INJURIES OF THE UPPER EXTREMITY. 

(A). INJURIES OF THE SHOULDER. 

188.— Simple fracture of the right clavicle : -J- Haraya, aged 20, a signal 
man of the Hiyei, in the battle of the Yellow sea, was signalling on the bridge, 
when an enormous shell of the enemy's exploded in the ward-room at the rear of 
the lower deck. He was thrown down against the railing of the bridge by the violent 
shock of the explosion. Thus the right clavicle was broken but as all the surgeons 
on board the ship had already been killed, he had to have the right arm simply 
supported by a piece of cloth ; until the ship arrived next morning at the rendezvous 
near Cape Choppeki, when he was attented to by a surgeon from another vessel, and 
on the 21st, was admitted to the Sasebo Naval Hospital. At the time, the right 
shoulder was depressed and the movements of the right arm could not be performed. 
When the arm was forcibly raised, a severe pain was complained of at the outer third 
of the clavicle, and crepitation was felt on the manipulation of the part; a small 
ecchymosis also existed in the same locality. The injured limb was fixed by a 
bandage. On the 30th of the month, he was transferred to the Kure Naval Hospital. 
By < >ctober KHh, the fracture had united. On the 2. r jth, lie left the hospital to resume 
service. 

189.— Compound fracture of right clavicle :— s - Hirokawa, aged 20 

crew of 17 C.m. gun of the b'tlso, in the battle of the Yellow sea, was resting by the 
port side of the funnel-casing, whin a hostile shell crushed the lower part of the 
funnel. From one of the broken pieces of the funnel, he received a blind wound on tin' 
outer side of the right clavicle. < )n examination, the entrance wound was found to be 2 
e. m. in vertical diameter, L.5 C.m. in transverse diameter, 6 C.m. in depth, and 
running upwards as far as the outer third of the hone, where an irregular Bqnare 
shaped iron piece of 2 c.m. long. 1 c.m. wide, and S m. m. thick was found lodged. 



INJURIES OF THE TJPPEK EXTREMITY. 131 

This was extracted aud the periosteum was found to be stripped off aud a part of the 
bone broken. An antiseptic dressing was appliel. On th? 21st, thi patient was 
admitted to Ihe Sasebo Naval Hospital. At that time, the wcuud developed 
granulation, with a slight suppuration. On October loth, the granulation entirely 
covered the surface of the bone, and no probe touched the bone. On the 28th, he 
was transferred to the Kure Naval Hospital when only a small surface of the size of 
a thumb tip remained, and this was gradually forming a cicatrix. On November 
19 th, he left the hospital completely recovered. 

190.— Contused wound of the left shoulder with crushed wound of 
the toes : — K- Matsuzawa, aged 2.3, Assistant Engineer of the Itsukushima, in the 
course of the naval engagement of the Yellow sea, on September 17th. 1894, was 
in the after boiler-room, when a hostile shell exploded against the ladder, after 
knocking through the middle step of the boiler room and piercing through the coal 
bunker in the waist on the starboard side. One of the fragments of shell inflicted a 
contused wound at about cm. below the spine of the left scapula. It was of an 
irregular square shape about 5 cm. in diameter and lacerated in a star-like form, 
and reached to the scapula, but without fracturing it. Resides, on the inner side 
of the right great toe, and on the outer side of the left little too, were found small 
lacerated wounds. After temporary treatment had been given, he was, on the 21st, 
admitted to the Sasebo Naval Hospital. At the time, the borders of the shoulder 

wound, and especially on the inner side of the scapula were swollen ; on examining 
the wound, a probe passed upward aud outward, measuring 4 cm., and discharged a 
little pus. The wounds of the toes had already dried. On the 29th, the inflamma- 
tion around the wound of the shoulder had subsided; yet the cavity of the wound 
remained wide, and the granulation was not favourable. Moreover the pus burrowed 
down forming a cavity : so a counter opening was made at the part to facilitate the 
discharge. On October 12th, the temperature suddenly rose to 39°. 8C, and (in- 
patient complained of headache, giddiness and thirst. On examining the wound, no 
remarkable change was found and pus escaped freely without accumulation. A dose 
of calomel was administered aud a wet carbolic compress applied to the wound. 
On the 14th, the temperature kept at 40° O. and an erysipelatous patch of the size 
of the palm was found around the wound. Ichthyol was applied, and the use of wet 
carbolic compress continued. On the loth, the temperature stood as high as before ; 
the area of the erysipelatous patch extended in all directions invading the parts over 



132 INJURIES OF THE UPPER EXTREMITY. 

the upper part of the spine of the scapula above ; the dorsal vertebrae on the right, 
the posterior border of the axilla on the left and the lower part of the scapula below. 
Ichthyol was continuously applied, and a mixture of tincture of perchloride of iron 
and sulphate of quinine was administered internally. On the 16th, the area of the 
patch still increased, reaching above to the root of the neck, on the left side, to the 
nipple line beyond the axillary border. It was. however, subsiding below. The 
wound was clean and the granulation favourable. The quantity of urine in 24 
hours was 400 grammes, containing albumen. On tin- 18th, the erysipelatous 
patch extended towards the arm. but in the other directions gradually subsided. 
After tlii' 20th. the extension of erysipelas ceased : and the quantity of urine 
increased to 800 grammes. On the 21st. the temperature began to lower : on the 
22nd. it fell to normal : and tin' patch around the wound had almost faded. On the 
20th. the erysipelas was completely healed. The wound of the shoulder continued to 
progress favourably, and the patient recovered on November 14th, and left the 
hospital to return to duty. 

191— Gutter wound of the shoulder:— Y. Nishimara, aged 21, crew of 
No. 6 Hotehkiss gun of the Akitsushima, in the battle of the Yellow sea, was 
standing by the No. 6 Hotehkiss gun on the port side on the waist part of the upper deck, 
when a hostile shell exploded against the shield of No. 5 side-gun on the starboard. 
One of the fragments of shell inflicted a grooved wound 8 cm. long and 3 cm. deep 
running transversely over the upper part of the spine of right scapula. The margins 
of the wound were cut sharp, they were sutured together, and the patient was taken 
on board a vessel bound homeward on the 19th and was admitted to the Sasebo 
Naval Hospital on the 21st. At this time, the wound had already suppurated, and 
no hope of the first union was entertained, so the stitches removed and the wet 
carbolic compress applied. Alter a time, pus discharged freely, the granulation 
presented a pale and swollen condition. Iodoform was sprinkled over it and a 
carbolic gauze applied. By the cud of November, the granulation improved ; pus 
discharge stopped, and a cicatrix gradually formed. On December 5th, he was 
perfectly rec »vered and left the hospital to return to duty. 

192— Perforating wound of the right shoulder and arm with contused 
wound of face : — S. Tagami, aged 26, crew of No. 7 gun of the Biyei, in the 
battle of the Yellow se;i, on September 17th, 1894, was tiring the No. 7 gun on the 
starboard side of the quarter-deck, when a hostile shell pierce. 1 through the ship's 



INJURIES OF THE UPPER EXTREMITY. I33 

sale just behind I lie port of thv said sun. crushing the wooden planks andiron- 
plating. Some of tbo iron pieces thus broken, inflicted wounds on the face, right 
scapula and arm. On examination, there was a lacerated wound of 3 c.m. 
running laterally above the right eyebrow, and a zigzag shaped lacerated wound, 
3 c.m. in length, running obliquely on the right cheek. These were both so 
shallow that only the skin was injured. Another lacerated wound shaped ||, and 
extending for 4 c.m. over the spine of the right scapula, was found reaching down to 
the surface of the bone, which was fractured in a line running outward from the point 
just below the spine of scapula. Another lacerated wound also existed on the posterior 
part on the upper third of the right arm. The wound measured 4.5 cm.; the 
entrance was turned out in a remarkable manner exposing the muscles in the shape 
of a crater. The canal of the wound ran upward and inward for about 12 c.m. and 
reached to the bone, producing an oblique fracture of the surgical neck of the hu- 
merus ; the broken ends kept their normal position without being displaced. 
Probably the iron fragment entered by the shoulder and passed out by the upper 
arm. Au antiseptic dressing was applied, and the upper limb fixed with a splint : 
the patient was taken on board a transport on the 19th and admitted on the '21st to 
the Sasebo Naval Hospital. On admission, the wounds of the upper arm and 
shoulder being cut open, the broken pieces of bone were extracted. After irrigation 
of the wound with carbolic lotion, a drainage tube was inserted. On the 24th, 
though the wounds on the face formed union by granulation, the wounds on the 
arm and shoulder were discharging abundantly ; the margins were inflamed, 
presenting a dark reddish colour ; the temperature indicated 3S G. On October 3rd ; 
the marginal inflammation of the wounds of arm and shoulder had disappeared, with 
diminution of discharge, and the temperature had fallen to normal from the 1st of 
October. To the right upper limb, a fenestrated plaster of Paris bandage was 
applied. From that time, the wounds progressed without any striking changes. 
By the beginning of December, the fracture of the upper arm produced a callus 
and the canal wound at last became narrower ; hence the plaster of Paris bandage wae 
removed. On January 30th, 1895, a cicatrix formed over the wound of the scapula, 
while that of the upper arm still retained a sinus which discharged more or less pus. 
On February 27th, the temperature suddenly rose to 40° C. attended by nausea and 
eadache. The bandage was removed, and the wound was examined, when a largs 
quantity of pus escaped from the sinus of the upper arm, yet the granula- 



134 INJURIES OF THE UPPER EXTREMITY. 

tion was healthy, and no sign of inflammation existxl. After irrigation 

of the sinus with carbolic lotion, a wet carbolic gauze was applied, and 15 gr. 
of quinine given. The next morning, the high temperature continued with nausea 
and vomiting. On March 1st, vesicles formed around the wound of the upper 
arm, ami a red patch over the upper part of the spine of scapula, presented characteris- 
tic signs of erysipelas. [chthyol was painted on the part, and strict antiseptic 
measures were continued tor the wound. Internally a mixture of quinine and 
tincture of perchloride of iron was given ; but the symptoms aggravated notwithstand- 
ing, and the erysipelatous patch extending more and more, the right upper arm, neck, 
and back were congested all over, finally affecting the face above and the buttocks 
below. The temperature had an irregular fluctuation, the patient became gradually 
exhausted and at length died from collapse on the 17th of March. 

193.— Perforating wound of the right shoulder, blind wound of 
right thigh and Abrasion of left leg:— T. Kashio, aged is. a stoker of the 

Itsuknshima, at the naval engagement of the Yellow sea, en September 17th, 189-1, 
was in the after boiler-room, when, after breaking through the coal-bunker of the 
starboard waist, a hostile shell exploded against the ladder set against the middle- 
step of the said boiler-room. Some of the fragments of shell, inflicted a perforating 
wound which entered by the outer end of the right clavicle and passed out at the 
upper part of the spine of the right scapula, and a blind wound just below the 
1'oupart's ligament of the right thigh. The patient was temporarily dressed on 
hoard and was admitted to the Sasebo Naval Hospital on the '21st. Examined at 
the hospital, the entrance wound at the outer end of the clavicle was found to he of 
an oval shape of the size of a thumb-head, and the exit in the scapular region to lie 
smaller and irregularly torn ; the wounds being probed into, fractures of the spine 
of scapula and outer end of clavicle were recognized. The wound at the upper part of 
tbe right thigh was not large enough to admit the end of the thumb, and taking its 
course inwards and downwards, it measured (i C. in. in depth, and a foreign substance 
was felt at the bottom. Bi idi -, on the inner side of the left leg were found three 
abrasions, which however had already been dried by the formation of scabs. Under 

an anaesthetic, the wound over the scapula Was cut open, and five broken pieces of 

bone of some 3 c m., were extracted from it. while from thai ol i lie right, thigh, a shell 
fragment of the size oi a thumb-head was extracted I ee the illustration No. 6). Che 
wounds were treated anti eptically. On October 28th, the wound at the inguinal 




INJURIES OF THE UPPER EXTREMITY. I35 

region healed by cicatrix, ami (hat of the scapula progressed 
favourably, so the patient was on that day transferred to 
Kure Naval Hospital. On December 22nd, though the wound 
of tbe scapula had healed, yet the movements of the joint 
were greatly impaired, and in addition, the upper limb on 

the same side was much emaciated, with an entire loss of 
Fig. 6. Fragment 01 
shell extracted from the grasping power. These defects were not recovered after a 
wound of right thigh. 

lapse of many months, so he was dismissed from service 

for life on the 10th of April, 1895, and was granted a pension according to the 
regulations. 

B). WOUNDS OF THE SHOULDEK JOINT. 

194— Contusion of the right shoulder and ankle joints with ab- 
rasion of scalp : — G. Okubora, aged 45, warrant officer of the Matsushima, in 

the course of the battle of the Yellow sea, on September 17th, 1894, was, in charge 
of the tackle-mending and of the carriers of the wounded, standing on the fore part 
of the upper deck, when a 30. 5 c. m. hostile shell burst against the shield of No. 4 
port-side gun on the fore part of the lower deck, and, at the same time set on 
fire a large quantity of powder provided for the side-gun. By the shock of the 
explosion, the upper deck was rent open and forced up, throwing hitu about 6 
yards backwards. At the time, noticing tire about him, he took a swab and tried 
to put it out, and for that purpose advanced some three steps in the smoke, when 
suddenly he fell down upon the lower deck through the gap just made in the upper 
deck. He sustained a contusion on the right shoulder and the right foot, with a slight 
abrasion on the head and left ear. At the time, the lower deck was filled with 
smoke and nothing could he seen, but ho managed to creep to a starboard port hole 
led by a faint light, and getting out through it, climbed along the ship's side upon 
the tipper deck, where he betook himself instantly to the work of extinguishing tbe 
tire. When the fire was put out, he was treated onboard the vessel. Conditions of 
the wounds : on the outer side of tbe right shoulder was a subcutaneous extravasa- 
tion, (the part becoming of a purple colour) attended by swelling and pains ; and over 
tin' outer ankle of the right foot another slight subcutaneous extravasation ex- 
isted, pain being felt on walking. Again on the left parietal region, and on the 
left ear, were seen abrasions of skin. To the injured parts of the shoulder and foot 



136 EXJ01UES OF THE UPPER EXTREMITY. 

was applied ;i lend lotion; and iodoform was sprinkled over those of the head and ear, 
which were then sealed with adhesive plaster. On the 23rd, the abrasion of the head 
and ear had accomplished union ; on the 30th, the swelling and pain of the shoulder 
and foot had entirely gone. 

• (C). INJURIES, OF THE ARM. 

195. — Contusion of the right arm:— K. Kawabata, aged 21, a seaman of the 
Hiyei, at the naval battle of the Yellow sea, was opening the door of the magazine 
under the lower deck, when a 30.5 cm. hostile shell exploded in the ward-room on 
the lower deck, thus breaking the deck and planks. One of the wooden splinters 
caused a subcutaneous extravasation of an irregularly oval shape measuring 3 cm. 
in diameter on the outer side of the middle part of the right upper arm, attended with 
an abrasion of skin at its center. A wet carbolic gauze was applied, and the part 
healed on the 21st of the same month. 

196. — Contusion of the left upper arm:— H. Kubo, a gunner of the Yoshmo, 
aged 28. In the course of the attack on the eastern forts of Liukung Island, Feb- 
ruary 7th. 1895. he was firing on the fort of No. 6 side-gun on the larboard, when 
a hostile shell hit the shield of No. 6 3-pounder on the port side. By one of the 
broken pieces of that shield, he sustained a contusion on the outer and back part of 
the left upper arm, where an abrasion of some 6 cm. square was inflicted with 
swelling, pain and extravasation underneath, but without any lesion of bone. A 
wet carbolic gauze was applied and the wound healed on the 17th of the same month. 

197. — II. Marubashi, Sub-Lieutenant of the Fuso, aged 27, at the naval engage- 
ment of the Yellow sea, September 17th, 1894, was engaged, on the fore-bridge, in 
surveying the distances of the enemy's vessels, when a hostile shell exploded on the 
upper deck, the shell-fragments tlew up and struck the semaphore signalstand, and 
one of them struck rebounding, the upper part of his left arm. On examination, an 
abrasion was found on the front and outer part of the left arm with an extravasa- 
tion under the skin around the wound. Marked swelling existed over the shoulder 
and the upper part of the arm, so as to interfere with five movements of the joint, 
but no injury of bone was found. A wet carbolic gauze was applied over the part and 
strict rest ordere 1. ( hi the 18fch, the swelling, aggravated extending down to the front 
part of the left side of the chest. On the 25th, the swelling decreased, and ecchy- 
mosis made its appearance on the upper and back part of the shoulder and the hack of 



INJURIES OF THE UPPER EXTREMITY. 137 

the upper arm. The abrased surface of the skiu presented a purplish-black colour. 
Gradually, the movements of the injured limb recovered, though an induration persist- 
ed in the outer end of the pectoralis major and the front part of the deltoid muscle. 
As the abrased wound had not yet healed entirely, on October 13th, the patient was 
sent to Sasebo Naval Hospital. At that time, the wound of the upper arm present- 
ed a round superficial granulating surface of 2 cm. in diameter ; its margins being 
covered with white newly-developed epithelium, and the borders of the wound still 
remained swollen and indurated. The shoulder joint could be passively moved from 
the side of the body to a right angle, but it was impossible to keep it in that 
position. To the surface of the wound boracic ointment was applied, and to the in- 
durated part, spirit of camphor. On the 29th, the abrasion of the skin healed, and 
the swelling greatly abated, yet the movements of the shoulder joint still resisted 
free motion. By December 14th, the induration of the part had almost disappeared 
and the movements of the joint at last returned. So on that day. he left the hospital 
and returned to duty. 

198. — I. Moriyaina, aged 28, a seaman of the Saikyo-marn, in the battle of the 
Yellow sea, was firing the 57 m.m. Q. F. gun at the stern of the upper deck, when 
a hostile shell exploded against the after most boat-davit on the starboard side. One 
of the fragments of shell inflicted an abrasion on the outer side of the middle part of 
the left upper arm. He complained of a slight pain: — carbolic oil and a bandage 
w-ere applied. On the 19th, the part healed completely. 

199.— Abrasion of the left upper arm with burns of the left hand :— 

S. Arai, aged 42, a senior nurse of the Yoshino, in the battle of the Yellow 
was standing in the surgery of the ward-room, when a hostile shell perforated the 
starboard nettings on the after part and exploded on the quarter deck, thus breaking 
the deck : and the fragments of shell fell into the ward-room. One of the fragments 
inflicted an abrasion 3 cm. long on the hack part of the lower third of his left upper 
arm, and the flame of the explosion gas gave him a slight burn in the middle of the 
back of the left hand. An antiseptic bandage was applied ; and the parts healed on 
the 21st. 

200.— Contused wound of the right upper arm :— Y. Nakashima, aged 27, 
a seaman of the Tenryu, at the time of the bombardment of the eastern fort of 
Liukung Island, February 11th, 1895, was hauling up shells for the forward revolving 
gun by means of a tackle, and standing by No. 2 hatch in the waist of the upper deck, 



13H INJURIES OF THE UPPER EXTREMITY: 

when a hostile shell hurst against the Xo. 2 side gun on the larboard waist of the upper 
deck. From one of the fragments of shell, he received a contused wound 1 cm. deep, 
of the size of a thumb-head, just above the internal condyloid eminence of the right 
upper arm. The margins of the wound were irregularly lacerated and attended by a 
slight hemorrhage. On introducing a probe, it was found that the wound formed a 
kind of sack, some ." cm. deep, running forwards under the skin ; the bone was intact 
and the movement of the injured limb not hindered at all. A sublimate gauze was 
applied and the patient was removed on board the hospital ship Kobe-rnarn. After- 
wards, the patient Lad a slight degree of motor and sensory paralysis of the ring and 
little lingers on the injured side. The wound gradually developed granulation and 
on the 20th, he was admitted to the Sasebo Naval Hospital. At the time, the 
granulation of the wound was found to he healthy and developing well ; but paralysis 
of the ulnar nerve prevented the function of the part supplied by that nerve. 
Antiseptic treatment was continued with suspension of the injured limb with a trian- 
gular sling. On March 15th, cicatrix formed on the wound, but the paralysis of the 
hand had not ceased, aud local bathing of the part, together with stimulating lini- 
ment, me • ige, ami the internal use of iodide of potassium were ordered. Afterwards, 
the conditions gradually improved and on April 6th, lie left the hospital to return 
to duty, completely recovered. 

-01.— Contused wound of the left upper arm ;— S. Mori, aged 24, Mid- 
shipman of the Matsushima, at the time of the attack on Liukuug Island, February 
2nd, 1SD.">, was on duty in the conning tower, when an enemy's shell passed over the 
bridge breaking an iron chain on its way. One of the severed rings of the chain flew 
into the tower and inflicted a contused wound I cm. in diameter and of sub-cuta- 
neous depth in front of the upper part of the left arm ; the margins of the wound 
were irregular and much swollen, the movements of the injured limb were hindered 
by pain; but no lesion of bone nor joint was found. Corrosive gauze was applied 
and the injured limb was secured with a triangular bandage The wound progressed 
favourably and healed under scales by the 28th of the same month. 

202. Lacerated wound of the left upper arm with burns of the face, 
neck and limbs: — C. Ariki, aged 2G, a seaman of the Matsushima. in the course of 
the engagement of the i'ellow sea, September 17th, 1894, was pa ing the fore part 
of the lowei deck, when a hostile 80.5 cm. shell exploded on the same deck, 
iguitiug at tin' same time the ammunition provided for the use of the side guns. 



IM.TURIES OF THE UPPER EXTREMITY. \W 

He sustained burns of the 2nd degree on the face, ears, neck, left arm down to the 
fingers, right forearm down to the fingers and on both legs ; moreover, a fragment of 
shell inflicted a lacerated w.mnd, (> cm. in length, on the posterior part of the left 
upper arm. Temporary treatment was given on board the ship, and, on the 20th, 
li ■ was admitted to Sasebo Naval Hospital. At the time the face was all covered 
with black scabs and the surfaces of the upper and lower limbs were denuded of 
epidermis, thus exposing the dermis and causing extreme pain. The lacerated wound 
of the left upper arm was located on the back part. :! cm. above the elbow joint, and 
had lacerated the greater part of the triceps. The wound was gaping and suppurating. 
It was antiseptically managed and the left upper arm was kept in an extended posi- 
tion. By October 3rd, the burns all healed by renovating epithelium except on the 
left ear ; and the wound of the left upper arm developed healthy granulation and the 
pus discharge ceased. On November 6th, the wound of the upper arm formed cica- 
fcric is, and the ulcerated surface of the left ear healed by scabbing. The elbow joint 
gave pain, when forcibly flexed so that its free movement was slightly hindered. 
Local bathing and active movement of the injured part were ordered, till the joint was 
at last restored to free movements, and the grasping power of the hand recovei 
On February 21st, 1895, he returned to duty. . 

203. — Gutter wound of tll3 right upper arm :— H. Sasaki, aged 35, Lieute- 
nant of the Akagi, in the engagement of the Yellow sea, was standing on the bridge 
engaged in measuring the positions of the hostile ships, when a fragment of explo I 
shell cam.' on the bridge from th ■ fore part of the starboard side, and hit him on the 
right upper arm. so that he lay down fainting for a while, but soon came to 
himself. On examination, a lacerated wound, 4 cm. in length, 1.5 cm. in width 
and 1.2 cm. in depth, was found running from the outer side towards the inner and 
lower part on the lower third of the right arm. The margins were irregularly lace- 
rated but as there was no injury to blood vessels, haemorrhage was not profuse : there 
was no lesion of bone. Under antiseptic precautions, the wound was sutured to- 
gether, a drainage tube introduced, iodoform sprinkled and a corrosive gauze applied. 
By the 23rd of the same month, the outer half of the wound had healed, but the 
inner half suppurated, so the sutures were removed. The granulation of the wound 
was unhealthy, presenting a grayish-colour, and discharging an offensive thin pus. 
Lotion of permanganate of potash was tried, with iodoform dusting, and wet carbolic 
compress, after which the granulation improved, and the pus discharge gradually 



]4u INJURIES OF THE UPPER EXTREMITY. 

lessened. By October 18th, the wound had healed by the formation of a slender 
cicatrix. 

- ' ' 4 . — Blind wound of right upper arm with burns of face and arm :— 

S. Furuta, aged 24, a magazine-man on the Matsnshima at the naval engagement 
of the Yellow sea, was hauling np shells in the fore magazine, when a 30.5 cm. 
shell from th i enemy struck the shield of No. 4 side gun in the fore part of the lower 
deck. One of the Hying fragments of shell inflicted a blind wound on the outer side 
of the middle of the right upper arm. The inlet of the wound measured 2 cm. in 
diameter and cm. in depth, the passage taking an upward and outward course 
through the soft tissues. At the same time the ammunition provided for the side- 
guns on the lower deck was set on tire, and he received burns from the flame of the 
explosion of l- f degree almost all over tie- face, and of 2nd degree on the outer side 
of the left upper arm. All the injuries were antiseptically treated and the patient, 
on the 20th, was conveyed t<> Sasebo Naval Hospital. In the hospital, wet boracic 
gauze was applied to the burns, and a counter opening was made to the blind wound 
on the right upper arm, a drainage tube was introduced and carbolic gauze ap- 
plied. On October Tth. tin' burns bad completely healed and on D< ci mbi r 17th, the 
wound of the arm was cured : so he returned to duty. 

205.— Blind wound of left upper arm :— J. Harauo, aged 21, stoker of the 
Itsukushima at the Naval engagement of the Yellow sea. was standing, as one of 

ire brigade on the uppermost grating in the fore engine-room on the upper deck, 
when a hostile shell exploded after penetrating the fore larboard netting. From our 
of the shell-fragments, he received a blind wound of the 3 in the front part 

of the upper third of the left arm. The inlet of the lacerated wound was 2 cm. in 
diameter, and located at the inner margin of the deltoid: it was 1 cm. deep reaching 
to the humerus but without injuring the periosteum or bono. After temporary treat- 
mi nt on board the ship, the patient was, on tin- 21st. admitted to the Sasebo Naval 
If pital. At that time, the wound was found to ho clean with very slight discharge 
of pus and an antiseptic bandage was applied. On the 30th, he was transferred to 
the Kure Naval Hospstal. Afterwards the case j I favourably and the surl 

of the wound cicatrized on the 14th October. However, as the injured limb could 
not be raised above the level of the shoulder and at the same time the grasping power 
was impaired, active movemi uts of the limb and stimulating liniment were ordered 
Thus free movement was gradually r< tor, ,l, and on November 5th, he returned to duty. 



INJURIES OF THE UFTER EXTREMITY. 141 

206.— Contused wound of the left upper arm with partial fracture of 
humerus : — Y. Koike, aged 27, Assistant Paymaster of the Tsukuslii, at the time of 
the bombardment of Zhih Island, February 3rd, 1895, was engaged in recording the 
state of engagement, under the bridge on the larboard side of the upper deck, when a 
hostile shell came in from the port side and pierced through the lower part of the 
funnel. One of the broken pieces of the funnel inflicted a contused wound 2 cm. 
in length, on the outer side of the lower end of the left upper arm, 5 cm. above the 
elbow joint. The skin and muscles of the part were lacerated and the bone was 
slightly depressed. The passage of the wound ran upward and backward -1 cm. 
along the surface of the bone forming a sinuous wound, which was attended with 
bleeding. "Within the wound no foreign substance was found. Corrosive gauze was 
applied. On the 7th, the torn flaps of the wound presented a grayish colour and 
suppurated a little. On the 15th, the sloughs were separated and the surface became 
clean and the granulation was healthy. By the 22ud, the wound became narrow and 
pus discharge ceased. Boraeic ointment and a bandage were substituted. The case 
was completely cured on the 28th. 

-"7.— Partial fracture of right humerus with glancing wounds of the 
head, face, limbs &C.: — M. Nagatomo, aged 10, a seaman of the Akitsushima, in the 

naval engagement of the Yellow sea, was carrying shells to No. 5 side-gun, when a 
well-directed shell hit the shield of that gun and burst. Seine of the shell fragments 
inflicted several wounds on the head, face, and upper and lower extremities. On ex- 
amination, three abrased wounds were found on the right parietal and occipital 
regions, one over the right frontal eminence and two on the right cheek ; each varying 
in size from that of a pea to the tip of the thumb ; on the median raphoe of the upper 
lip a vertical lacerated wound was seen ; and the right half of the face was burned, 
grains of powder still remaining in numberless spots. On the outer side of the lower 
part of the right upper arm there was an oval lacerated wound, 5 cm. in length and 
8 cm. in breadth, which reached the bone denuding the periosteum of the humerus and 
breaking the walls of the shaft, which, however, was found to be not entirely broken. 
Also on the back of the upper part of the right arm a contused wound, and three on 
the outer side of the right forearm were found, which were, however, all superficial, 
not reaching beyond the subcutaneous areolar tissues. Moreover, in the inner side of 
the left foot another abrased wound of the size of a 1 sen copper coin was found. All 
the wounds having been autiseptically treated, the patient was conveyed to the Sasebo 



142 INJURIES OF TUE UPPER EXTREMITY. 

Naval Hospital by a transport setting s lil on the 19th. At the time of admission, the 
right upper arm was considerably swollen, and the wound of the lower part of the 
arm was suppurating. All the other wounds presented favourable conditions. The 
wound above the right elbow was scraped with a sharp spoon and the free pieces of 
bone extracted. The arm was dressed with wet carbolic gauze; other wounds were 
sealed with dry corrosive gauze. Burns of the face were of the first degree, though 
some parts were of the second degree and sterilized olive oil was painted on them. 
On October 1st, the abrased wounds and burns on the bead and face dried up. 
Wounds of the upper lip, upper arm, forearm, and on the foot, became smaller, and 
the pus discharge nearly ceased. The lacerated wound above the right elbow 
gradually threw out healthy granulation and the swelling of the arm subsided. By 
the 11th of the same month, the abrased wounds of the several parts had all healed, 
except the lacerated one above the elbow, which, however, had now grown shallow 
and small by the gradual development of granulation, still there was a discharge of 
pus from it and on being probed the bone was reached ; but the progress was favour- 
able and by the 24th of November, it was completely healed. But the right elbow 
joint ankylosed in the position of 90 degrees ; and it could not be extended, even with 
forcible efforts, beyond 95 degrees. By local hot bath, and active and passive move- 
ments, the joint was gradually extended to 140 degrees. But the movement could 
not be perfectly restored, and he was discharged from duty fir lite on March 16th, 
1895 and left the hospital. He was granted a pension according to the regulations. 
(See illustration, i 

208.— Blind wounds of the right arm with lesion of the bones:— K. 
Wakikawa, aged 20, a servant to the Captain of the Hiyei, in the course of the naval 
engagement of the Yellow sea, was working at tb pump of tb rentilator in the 3rd 
quarter of the lower deck, when an enormous shell of the enemy exploded ii: 
ward-room in the 5th quarter. One of the shell fragments inflicted blind wounds on 
tlii- right upper and fore-arm. As all the medical staff in the ship were killed by 
this same shell, the wounds had to be dressed tor temporal - } relief by his mates, and 
it was not until the ship arrived at tin station near Cape Ghoppi ki n xl morning, 
he could be properly treated bj a surgeon from another ship. Condition "i I i 
wounds: — In front of the upper pari ol tin- right arm an irregular lac •and 

2.5 cm. in diameter and ii cm. in depth was found, which took an upward© 
towards the inner and lower part of the surgical neck of the humerus ; by digital 




4V- 






M. NAGATOMO. 2nd ORDINARY SEAMAN/AKITSUSHIMA" I. J.S. 
WOUND OF CULOE SAC OF THE RIGHT UPPER ARM WITH FRACTURE OF THE HUMERUS AND SEVERAL WOUNDS OF OTHER PARTS. 




INJURIES OF THE UPPEll EXTREMITY. 143 

examination a shell-fragment was recognized inserted in the hone, which was 
extracted. Also on the hack of the lower fourth of the right fire-arm, a lacerated 
wound as large as the tip of the thumb was seen ; the passage of the wound ran up- 
wards to the depth of 3 cm. reaching to the radius which was fractured. The wounds 
were dressed antiseptically, and the patient was conveyed to the Sasebo Naval 
Hospital on the 21st of the same mouth on board the transport Genlcai-marn. Both 
wounds continued to discharge pus mixed with pieces of broken hone ; so on October 
1st, under the influence of an auassthetic the inlets of the wounds were cut open and 
examined. The shaft of the humerus just below the surgical 
neck was found to be severed so as to reach the medullary 
canal, but without complete fracture, also, at the bottom of the 
wound of the fore-arm, a small shell-fragment (as shown m 

figure 7) was found and a fissured fracture of the radius. The Fig 7Fraguiento£ 

shell extracted from 
fragment of shell in the forearm and the pieces of broken bone the wound of rig 

..... ., forearm. 

were extracted ; then the wound was dressed antiseptically and 

a drainage tube introduced to the wound of the arm. After the operation there was 
a slight rise in the temperature, but in two or three days it returned to normal again ; 
the pus discharge gradually subsided and healthy granulation developed. By the 5th 
of November, the wound of the fore-arm had healed, leaving no derangement of the 
movements of the radius. The wound of the upper arm still discharged pus and mi 
probing a coarse surface of bone was felt. By the middle of December, the pus dis- 
charge had greatly diminished so that the dressings had to be changed only every 
three days. Short!}" after, the surface of bone became completely covered by callus 
and the coarse surface of bone could no longer be felt. The drainage-tube was re- 
moved and by March Gth, 1895, the wound of the upper arm formed a depressed 
cicatrix without leaving any marked derangement of the movements of the limb, so 
the patient left the hospital and returned to duty. 

209. — Penetrating wounds of both humeri with perforating wound of 
chest and blind wound of the back &C :— M. Fnjii, aged 28, a seaman pf the 
Itsukushima, in the naval battle of the Yellow sea, was passiug behind the bow gun 
on the upper deck, when a hostile shell exploded after coming through the port nett- 
ing. Some of the flying shell-frameuts inflicted a large wound 15 cm. in length and 
5 cm. in diameter on the left side of the back at the 10th rib. The rib was broken, 
the chest wall pierced and the lung perforated so as to let air mixed with blood escape, 



144 INJURIES OF THK UPPER EXTREMITY. 

from tha wound producing emphysema under the skin. Besides this the following 
wounds were found : — Above and inside of this wound was an abrased wound in an 
oblique line, above and outside two similar ones, a contused wound at the inner 
margin of lb • right scapula, and sis smaller contused wounds on the outer side of the 
right thigh. Moreover, the right upper arm at the middle third and the left at the 
lower third wi re pierced from the back to the front. The humeri were both fractur- 
i nt the brachial arteries escaped injury and bleeding was not great. Antiseptic 
tri atment was immediately given to all the wounds and splints applied to the arms, 
tin patient was removed on the 10th on board a vessel bound for home and admitted 
to tin 3 o Naval Hospital on the 21st. At the time, the wounds were inflamed, 
discharged pus. and on the left side of the chest subcutaneous emphysema existed. 
On examination, both humeri were found to be broken through transversely, small 
litre- of bone sticking into the surrounding muscles and the wound canals formed 
hollow cavities. The rib was broken obliquely, and its inner end penetrated into the 
wound. The pointed end was sawed away to make it smooth, the free pieces of the 
broken humeri extracted, drainage tubes introduced, perforated plaster bandages ap- 
plied, and the wounds irrigated every day. In due course of time, the abrased wounds 
on the back and right thigh healed, but the penetrating wound of the chest still 
caused trouble. By October 1st, the subcutaneous emphysema of the chest had ( it- 
tended down to the hypogastric region ami even to the scrotum, so tight bandages 
were applied. On the seventh, a swelling, the size of a bean, was discovered on the 
light inter-scapular region, an 1 on fe ling it a solid body was found to move under 
the skin. It was cut open and an irregular fragment of shell was obtained. By the 
15th, the chest wound had developed granulation, the perforation of the thoracic 
cavity was perfectly closed so that the air did no longer escape from the lung and the 
itaneous emphysema had almost disappi ired. The wounds of both upper arms 
still bad a copious discharge, but minuti piec ol bori . like grains, clogged tin' 
canals of the wounds obstructed the flow of pus, and consequently the temperature 
was iucreo the wounds were enlarged to give a free discbarge. On November 

12th, . ■, d a cicatrix, but tbe wounds of the upper arms were still 

By March liSth. 1895, the fractures of both arms had united, ami the 
wound of irm healed, bui thai of the right still discharged pus slightly, with 

occasionally minuti : . The derangemenl of tbe right musculo-spiral 

nervi ised drop-wrist and anaesthesia of the parts which it sup- 




M.FUJII. LEADING SEAMAN 'ITSUKUSHIMA, US 
PERFORATING WOUND OF BOTH UPPER ARMS WITH FRACTURE OF HUMERUS AKO PENETRATING WOUND OFTHE LEFT THORAX WITH FRACTURE OF RIB 



INJURIES OF TEE UPPER EXTREMITY. I45 

plied, and the grasping power of the right hand was entirely lost. On May 3rd, the 
patient was transferred to the Euro Naval Hospital. The granulation of the wound 
continued to develope gradually, and the discharge of pus ceased. By October 22nd, 
the wound had entirely healed, but the paralysis of the right rnusculo-spiral nerve 
remained as before, and the grasping power was no more than 5 k.g. The patient 
was therefore adjudged unfit for service, so on December 20th, he was invalided for 
life and left the hospital. He was pensioned according to the regulations. (See 
illustration.) 

(D). INJURIES OF THE ELBOW JOINT. 

210.— Contusion of the right elbow joint :—H. Kadotani, aged 23, a sea- 
man belonging to the Tenryu, in the course of the attack on the eastern fort of Liu- 
kung Island, was working as a shell-carrier, in the after cock-pit, when a well-direct- 
ed shell burst against the No. 2 gun on the larboard side of the upper deck, and broke 
the brass railing of the 3rd hatch, one of the broken pieces of the bar fell on his right 
elbow causing a subcutaneous extravasation of blood in the extensor side of the joint, 
which gave rise to pain on flexion. The joint was kept at a suitable position and 
dressed with a carbolic lotion. By the 17th, the swelling as well as the pain h id 
greatly decreased, and the movement of the elbow was almost restored. Tincture of 
iodine and a tight bandage was applied and by the 22nd, the lesion had entirely 
healed. 

211.— Contusion of the right eibow joint and contused wound of the 

left leg: — C. Sasaoka, aged 25. Sub-Lieutenant of the Matsushima, in the en- 
gagement of the Yellow sea, was officer commanding the fire brigade on the lower 
deck, when a 30.5 cm. hostile shell exploded striking the shield of the larboard No. 
4 side-gun on the fore part of the lower-deck. This caused all the shells aud powder 
provided for the side-guns to explode at once, and by the shock he was thrown back 
aud sustained blows on the back part of the parietal region, the right shoulder, and 
the right elbow joint ; besides, by one of the broken pieces of the ship's planks, he 
received a contused wound in front of the middle of the left leg. At the moment 
of injury, he lost consciousness, but soon came to, and betook himself to putting the 
fire out ; and when it was extinguished, he received treatment on board the ship. 
The contusions of the head and shoulder were slight, so the swelling and pain disap- 
peared in a few days. But the swelling and pain of the right elbow joint became 



146 INJURIES OF THE UPPER EXTREMITY. 

aggravated, and the wound of the left leg did not heal, so the patient was admitted to 
the Sasebo Naval Hospital on the 23rd of the month. At the time, the outer side of 
he right elbow joint presented a purplish blue colour, and the joint was swollen all 
around, so that its movements were attended by pain, but no injury of either bone 
could be found. Again, in front of the middle part of the left leg a superficial 
granulating wound, 3 cm. long and 2 cm. wide, was present, which did not affect 
cither the periosteum nor the bone. The right elbow joint was dressed with acetate 
of lead lotion, and the wound of the leg with a carbolic gauze. On the 29th the con- 
tused wound of the leg formed a cicatrix, and the inflammation of the elbow joint 
gradually subsided, so that it could now be freely moved. On the 30th, the patient 
left the hospital to resume service. 

(E). INJURIES OF THE FOEE-AEM. 
212— Glancing wound of the right fore-arm : — 0. Kosono, aged 29, a 

seaman of the Yoshino, in the course of the engagement of the Yellow sea, was 
standing by the side of the 12 cm. gun on the larboard side of the quarter deck, when 
a hostile shell came through the starboard netting and struck the shells of 12 cm. 
guns placed in rows along both gunwales, causing them to explode. One of the shell- 
fragments inflicted an abrased wound 1.5 cm. long on the back part of the upper 
third of the right fore-arm. A corrosive gauze was applied and on the 21st it healed 
by scabbing. 

213.— Contused wound of both fore-arras ;— Y. Fukagawa, aged 24, a sea- 
man on the Saikyo-maru, in the battle of the Yellow sea, was firing on the fort with 
the 57 m.m. Q.F. gun, at the stem of the upper deck, when a shell of the enemy hit 
the aftermost starboard boat-davit and exploded. Some of the shell-fragments ba- 
ted a contused wound 1 cm. long and C m.m. deep on the back part at the middle 
of the right fore-arm, and another one of 6 m.m. long and 3 m.m. deep on the radial 
ide of the lower end of the left fore-arm. The margins of the wounds were lacerated 
and attended by slight hemorrhage. Within them no foreign bodies were found, 
[odoform and carbolic gauze were applied and in due course the <urfaoes of the 
wounds di relopi I granulation, and the lesion on the left fore-arm healed by October 
11th, but that of the right fen -arm produced a burrowing of pus beneath the margins 
of the wound and granulation was (lull, so the wound was cut open, the unhealthy 
granulatii ped off, and carbolic gauze applied, Then the granulation steadily 



INJURIES OF THE UPPER EXTREMITY. I47 

improved, the pus discharge decreased, and on November 3rd, it had healed by 
cicatrix. 

214.— Contused wound of the right fore-arm ;— M. Kawamura, aged 24, a 
guncrew ou the Katsuragi, in the course of the bombardment of the eastern fort of 
Liukung Island, sustained a contused wound ou the back part of the upper third 
of right fore-arm by one of the splinters of wood caused by the breaking of the ship's 
planks by a hostile shell. In the course of a few days the wound suppurated, and the 
temperature rose to 38°. 1 C, so the dressing was changed daily, and in a few days 
more, the temperature became normal, the inflammation around the wound subsided 
and on March 18th, cicatrix formed. 

215. — T. Takata, aged 21, a guncrew of the Katsuragi, in the course of the 
bombardment of the eastern forts of Liukung Island, had just rotated the fore- 
revolving gun, when, owing to the shock caused by a hostile shell knocking the barrel 
of the gun, he was thrown down, and at the same moment he was struck by a wooden 
splinter and sustained a shallow wound on the back of the upper part of the right 
fore-arm. Besides, he complained of pain on the right side of the chest in breathing, 
where he had received a blow when thrown down, but no physical signs were found 
on examination. A corrosive gauze, to the wound was applied and the patient order- 
ed to rest. On the 21st, the wound had completely healed forming union under a 
scab. 

210— Contused wound of the right fore-arm and contusion of the face :— 
S. Hamanishi, aged 24, a seaman of the Yoshino, in the attack of the eastern forts 
of Liukung Island, was standing on the fort of No. G 3-pounder above the port nett- 
ing on the quarter deck, when a shell hit the shield of that gun, and some of the 
broken pieces of the shield, inflicted a contused wound on the face and another on the 
right fore-arm. On examination, the left cheek and the tip of the nose had their skin 
abrased and swollen, the left eye-lids were strikingly swollen and the conjunction 
congested. Besides this on the inner side of the lower third of the right fore-arm, 
there was a contused wound some 2.5 cm. in length, which had irregularly lacerated 
margins and reached the sub-cutaneous tissue. An antiseptic bandage was applied, 
and next day the patient was removed to the hospital ship Kobe-maru. The abrased 
surfaces of the face gradually healed, the swelling of the eye lids subsiding at the 
same time. The wound of the fore-arm presented no signs either of suppuration or 
inflammation. The face was protected with a bandage and the fore-arm dressed with 



148 INJURIES OF THE UPPER EXTREMITY. 

corrosive gauze. On the 11th, the patient was admitted to the Sasebo Naval Hospital. 
The injuries of the face healed before long, and that of the fore-arm developed favor- 
able granulation with gradual formation of epithelium. On the 27th of the same 
month, the patient left the hospital completely cured. 

217.— Contused wound of the left fore-arm:— M. Tajima, aged 26, a sea- 
man on board the Hiyei, in the course of the engagement of the Yellow sea, was 
working with the elevator of No. 9 gun in the stern, when a shell broke through the 
stern port to starboard. One of the flying wooden splinters caused a contused wound 
18 cm. long and 5 cm. wide, running downward and outward from the elbow along 
the back of the upper third of the left fore-arm, and changing its direction in its 
course to downward and inward. The margins of the wound were lacerated but the 
skin only was pierced. An antiseptic bandage was applied, the wound progressed 
favourably and on October 6th perfectly healed by forming a cicatrix. 

218.— Gutter wound of the right fore-arm :— S. Tanaka, aged 34, chief 

gunner of the Hiyei, in the course of the naval fight of the Yellow sea, in order to 
get ammunition, was passing in front of the gun-room in the 4th quarter on the lower 
deck, when an enormous shell of the enemy exploded in the ward-room of the 5th 
quarter and caused a wound on the right fore-arm by one of the shell -fragments. 
As all the medical staff on board were killed at the time, he had to he only tem- 
porarily dressed by a shipmate, and was properly treated by one of the surgeons from 
another ship, when she arrived at the station near Cape Choppeki next morning. 
Condition of the wound : — On the ulnar side at the upper third of the right fore-arm 
was found an oblong grooved wound 3 cm. in length and 1.5 cm. in width running 
obliquely. The bottom of the wound reached beneath the skin, but without giving 
any injury to the muscles or bones. An antiseptic dressing was applied, and by 
October 7th, the granulating surface of the wound had grown new epithelium from the 
borders, zinc ointment was applied, and by the 24th the wound was perfectly healed. 
219.— Gutter wound of the left fore-arm:— Y. Wakinaga, aged 25, one of 
the torpedo crew belonging to the Matsusliima, in the engagement of the Yellow 
sea, was on duty in the middle torpedo-chamber on the starboard side, when a 80.5 
cm. hostile shell exploded in the fore part of the lower deck and one of the shell- 
fragments breaking into the said chamber through the bulkhead inflicted a grooved 
wound C cm. long, 4 cm. wide and 1. 5 cm. deep, running laterally from the radial 
side to the ulnar on the hack part of the lower fourth of the left fore-arm. Tern- 



INJURIES OF THE UPPER EXTREMITY. 149 

porary dressing being applied on board, the patient was transferred to the Sasebo 
Naval Hospital on the 20th. At the time, the margins of the wound were everted 
presenting a shape like a flower, and of a dark purplish colour with sloughs at several 
spots ; the granulation at the bottom was unfavourable. Iodoform was sprinkled on 
and a wet carbolic dressing applied. On the 29th, burrows, each some G cm. long 
were produced beneath the skin, one above and one below the wound, and as the 
escape of pus was obstructed they were cut open on October 5 th, the pus discharge 
decreased, and granulation improved. By January 12th, 1895, the wound had com- 
pletely cicatrized. The movement of the injured limb, was not interfered with, but 
the grasping power was somewhat diminished. A protecting bandage was applied, 
and frequent active movements of the limb were ordered. On February 9th, he left 
the hospital and returned to duty. 

220.— Non-perforated wound of the right fore-arm:— 0. Okamura, aged 
24, a guncrew of the Akagi, in the course of the battle of the Yellow sea, was by 
the side of No. 3 12 c. m. gun in the waist of the upper deck where he was engaged 
in firing, when a fragment of a broken shell came flying in from the starboard side 
and inflicted a wound on the right fore-arm. On examination, on the inner side of 
the middle of the right fore-arm a lacerated wound 2 c. m. in diameter was found; 
the margins were irregularly torn attended by bleeding and pain. When probed, the 
wound measured 5 e. m. running in a downward direction, and a foreign body was 
discovered, so the wound was incised and a shell fragment (see the figure 8.) was ex- 
tracted by a pair of bullet forceps ; on further search in the wound along the inner 

border of the ulna, the periosteum was found to be strip- 
ped off. The blood vessels were ligatured and an anti- 
si ptic dressing applied. On 18th, the margins of the 
wound became slightly swollen; but treatment was con- 
Fit:. 8. Fragment of shell tinned as before. The patient was taken on board the 

extracted from the bottom of tl .. msport 011 the 1!)tU) and couve yed to the Sasebo Naval 
the wound of the forearm. 

Hospital on the 21st. As there was a tendency to accu- 
mulation of pus in the wound a counter opening was made below the wound canal of 
the fore-arm, a drainage tube introduced and an antiseptic dressing applied. On the 
28th the granulation hi the canal protruded from the wound orifice presenting a pale 
appearance, it was rubbed over with nitrate of silver and au iodoform dressing app- 
lied. On October 6th, the pus discharge from the wound decreased considerably, the 




150 INJURIES OF THE UPPER EXTREMITY. 

swelling around the wound disappeared and the granulation grew bright red so that 
every condition was now auspicious. On the 28th, the patient was transferred to the 
Eure Naval Hospital. On November 25th, the wound formed a cicatrix, but owing 
to the cicatricial adhesion of the deep flexors, free movements of the ring and little 
fingers were hindered. Local warm bathing, massage and active as well as passive 
motions of the said fingers were persevevingly performed and by December 23rd, the 
movements of the fingers had greatly improved, so that the flexion of these fingers 
was imly slightly hindered. On that day, the recovered patient left the hospital to 
return to duty. 

221.— Non-perforatsd wound of the right fore-arm and contused 

Wound of the fingers : — S. Sage, aged 30, a petty officer of the Hiyei, in the naval 
engagement of the Yellow sea, was at the wheel on the quarter deck, when an enor- 
mous shell of the enemy exploded in the ward room at the stern of the lower deck. 
The shell fragments, broken pieces of plank and furniture flew out of the sky light of 
that room, and some of them inflicted a blind wound on the back part of the middle of 
tho right fore-arm, and contused wounds on the right index and middle fingers. This 
enormous shell also killed all the medical staff on board, and the patient had to be 
temporarily dressed by a shipmate, and was properly treated by a surgeon from 
another ship, when the vessel arrived at the station near Cape Choppeki next morn- 
ing. On the 20th of the same month, he was admitted to the Sasebo Naval Hospital. 
Conditions of the wounds: — On the back part at the middle of the right fore-arm was 
a lacerated wound 8 c. m. in diameter, and 3 c. in. in depth running in an upward 
direction. The margins of the wound were slightly swollen, with a discharge of pus 
and foreign bodies were found at the bottom, which, being extracted, proved to be five 
or six pieces of buck-wheat husk. At the root of the right index and middle fingers 
small contused wounds were found which were, however, already healed. An anti- 
septic (hissing was applied, to the wound of the fore-arm. On the 30tli following, 
the patient was transferred to the Kure Naval Hospital, where inure pieces of buck- 
wheat husk were taken out of the wound. On November (ith, he left the hospital 
completely recovered and returned to duty. 

222 —Perforated wound of the left fore-arm, glancing wound of the 
left leg and burns of face : — H. Nakata, aged 23, a stoker on board tin- Matsu- 
shima, in the tight of the Yellow sea, was on duty in the engine room, when a hostile 
-lull exploded in the neighbourhood of tin after-engine room and broke the wall 



INJURIES OF THE UPPER EXTREMITY 151 

plate at the entrance of the room. Some of the iron fragments inflicted a perforating 
wound of the right fore-arm and an abrased wound of the left leg, and burns on the 
right side of the face by explosion gas. Believing measures were taken temporarily, 
and the patient was admitted to the Sasebo Naval Hospital on the 20th following. 
On examination, on the outer side of the left fore-arm at a point 3 c. m. below the 
elbow joint, two orifices were found communicating beneath the skin. A probe 
reached the radius, but no lesion of bone nor existence of foreign body was discover- 
ed. The margins of the wound were somewhat swollen presenting a purplish colour. 
On the outer side of the middle of the left leg were found an abrasion, and a burn of 
the second degree on the right side of the face. Corrosive gauze was applied to the 
wounds, and to the burns wet boracic dressing. By October 13th, the burns of the 
face and the abrasion of the leg had healed. But the wound orifices of the left fore- 
arm contracted and led to an accumulation of pus, so an incision was made. 
Consequently, pus was discharged freely, and favourable granulation developed. On 
December 7th, cicatrices formed, but the adhesion of muscles to the bono prevented 
rotation and pronation of the fore-arm. Local bathing and active movements were en- 
couraged, and on the 19th following, though the movements of the injured limb were 
not completely restored, yet being adjudged able for service, he was ordered to return 
to duty. 

223.— Fracture of the right ulna and the first phalanx of the right ring 

finger : — F. Nagasaka, aged 23, one of the crew of the No. 7 gun of the Hiyei, in the 
engagement of the Yellow sea, was firing from the fort of the gun on the starboard 
quarter deck, when a hostile shell came through the ship's side just behind the gun. 
The flying wooden splinters inflicted fractures of the right ulna and ring finger. 
Temporary relief was given on board, and the patient was admitted to the Sasebo 
Naval Hospital on the 21st of the same month. Conditions of the wounds : — The 
right fore-arm was much swollen, especially below the middle part, and at the junc- 
tion of the middle and lower third of the ulna crepitation was felt. Besides, on the 
back of the first phalangeal joints of the right ring and little fingers, as well as on the 
upper arm small contused wounds were foimd. There was also a fracture of the first 
phalanx of the ring finger. The fore-arm was encased with plaster of Paris bandage. 
On the 30th following, the contused wounds on the right arm and index finger healed. 
The swelling of the fore-arm subsiding the plaster bandage became loose, so it was 
replaced by a splint. The same day the patient was transferred to the Kure Naval 



152 INJURIES OF THE UPfER EXTREMITY 

Hospital, and by the middle of October, the fracture of the ulna and ring-finger was 
completely united, but as the extension and flexion of the ring and little fingers were 
greatly interfered with, the grasping power was strikingly decreased and with the 
right hand heavy things could not be lifted. By the diligent repetition of active 
movements, the recovery of the injured limb was sought for, but as it was almost 
hopelessly delayed in recovery, the patient was, on February 9th, 1805, invalided for 
life, and pensioned according to the regulations. 

224.— Compound fracture of the left fore-arm with blind wound of 
the upper arm:— K. Funakoshi, aged 20, a stoker on board the Itsukuskima, in 

the naval engagement of the Yellow sea, was working in the after boiler-room, when 
a hostile shell came through the starboard coal-bunker amidships and exploded 
against the ladder set against the middle step in the after boiler-room. Some of 
the shell-fragments wounded him on the left upper and fore-arm. The wound of the 
upper arm was a lacerated one, of the size of the tip of the thumb, located at the 
junction of the upper and middle third of the antero-external side, it reached to the 
bone but without any injury to it. That of the fore-arm was an oval shaped lacer- 
ated wound 8 c. m. in diameter at a point c. m. below the elbow joint and a little 
behind the ulnar side. The wound ran in an upward and outward direction and a 
shell-fragment remained at the bottom. The upper part of the ulna was broken, and 
the brachial artery rent at the bifurcation, so that the pulsations of the radial and 
ulnar arteries ceased, but haemorrhage was not profuse, and the radius escaped in- 
jury. Besides, in the middle of the extensor surface of the left fore-arm, and below 
a small abrased wound was found. The wounds were dressed with corrosive gauze. 
On the 21st of the same month, the patient was admitted to the Sasebo Naval 
Hospital. At the time, the injured limb presented a purplish blue colour below the 
elbow joint, the skin was cold, and the wound emitting a putrifying smell, indicating 
gangrene. So amputation of the arm was immediately performed at the middle of 
the upper arm by the circular method. The flap was stitched together and a rubber- 
tube inserted and covered by an antiseptic bandage. Strong nutritions and tonic 
measures were ordered. On October ;!rd, the flap having healed by the first intention, 
the threads were removed. By the 28th, the strength of the patient was returning 
and s i he was transferred to the Kure Naval Hospital. On December 3rd, the cica- 
trix of the stump was yet tender, s i the part was protected with a bandage. On the 
26th of the sun i m mth a certificate that he was disable 1 for life was forwarded I > 




k. funakoshi, fovrtii (lass stoker. 

ax example of the artificial arm given 

by Her Majesty the Empress. 




INJURIES OP THE UPPER EXTREMITY. 153 

the admiralty, Her Majesty the Empress granted him an artificial limb, and he was 
discharged from the service. He is pensioned according to the regulations. (The 
artificial limb granted is shown in the illustration.) 

225.— Fracture of the left fore-arm and left 3rd rib with burns of 

face &C- : — T. Shinozaki, aged 34, a gunner of the Hashidate, in the course of the 

battle of the Yellow sea, was firing in the fort of the 32 c. m. gun on the fore part 

of the upper deck, when a shell of the enemy burst against the inner surface of the 

gun-shield and the .shell-fragments inflicted two blind wounds 

each 1.2 c. m. long at a part 5 c. ru. above the wrist-joint in the 

front of the left fore-arm. The margins were lacerated, the wound 

reached to the bone, breaking the radius, and within the wound 
Eig. 9. Fragment ° 

of shell extracted was a cubical shell-fragment (see figure 9.) 1.5 c. m. in diameter, 

from the wound of whi(jb wag extl . actetl . Besides, over the sternal end of the left 
the left fore-arm. 

third rib was found a contused wound ; with the fracture of the 

same costal cartilage beneath the skin. On the right side of the face, there was a 
burn of the second degree, and many minute shell-fragments and powder grains were 
seen in the right temporal region, the right, membrana tympanum was also ruptured. 
Temporary measures were given for relief on board, and the patient was, on the 
21st, conveyed to the Sasebo Naval Hospital. At the hospital several broken pieces 
of bone were extracted from the wound of the fore-arm, and very small shell-frag- 
ments more than ten in number were likewise removed from the temporal region. 
The wounds were dressed under strict antiseptic measures. The fracture of the rib 
cartilage was fixed with strips of adhesive plaster, and the rent of the right tympanic 
membrane stuffed with an antiseptic cotton plug. On December 10th, the wound 
on the temple had healed, and the fracture of the rib cartilage united, but the per- 
foration of the membrana tympanum was not closed yet, and the hearing was impair- 
ed but without any discharge of pus. On April 3rd, 1895, the wound on the left fore- 
arm had healed, but the movements of the wrist joint were greatly interfered with ; 
the perforation of the tympanic membrane still remained unhealed. However, the 
patient had recovered sufficiently to enable him to return to duty. 

(F). INJURIES OF THE HAND. 

226.— Contused wound of the left palm :— C. Ishii, aged 36, a petty officer 
of the Matsushima, in the course of the engagement of the Yellow sea, was carry- 



154 INJURIES OF THE UPPER EXTREMITY. 

ing a wounded man to the surgery in the fore part of the upper deck, when a 30.5 
c. m. hostileshell exploded in the fore part of the lower deck, and caused all the 
ammunition provided for the side-guns to explode at once, so that the upper deck was 
forced up and rent open hy the shock. A flying wooden splinter hit the hall of the 
left thumb inflicting a contused wound 2 c. m. in length and 1 c. m. in width. It 
was directly dressed with corrosive gauze. On October 3rd, it had healed by scab- 
bing. 

227.— Perforated wound of the left hand and burns of both fore-arms : 

— T. Umehara, aged 20, a junior bandsman, on board the Matsushima, in the battle of 
the Yellow sea, was standing in the fore part of the lower deck, to act as a carrier of 
the wounded, when a 30.5 c. m. hostile shell burst against the fort of No. 4 larboard 
gun of the same deck, and ignited the powder provided for the side-guns. One of the 
shell-fragments inflicted a perforating wound on the ball of the left thumb, and he re- 
ceived burns of both fore-arms. Temporary measures were directly given on board, 
and on the 20th of the same month the patient was conveyed to the Sasebo Naval 
Hospital. Conditions of the wounds : — The burns presented the symptoms of the 2nd 
degree, the skin mostly denuded and exposing the red surface of the true skin. Tin- 
wound of the left hand had a round entrance orifice on the inner side of the thumb- 
ball, which measured 2 c. m. in diameter, and the passage of the wound was around 
the radial side of the 2nd metacarpal bone and found its exit on the back of the hand. 
The exit wound was somewhat larger than the entrance one, and the skin was rent 
open. The burns were dressed with vut boracic gauze, and the wound of the thumb 
with carbolic gauze. By October 11th, the burns healed, and the wound of the hand 
much improved. The patient was transferred, on the 28th, to the Kure Naval Hospi- 
tal. On December 10th, he left the hospital to return to duty. (After the recovery 
of the wound flexion of the left thumb and index finger was slightly interfered with, 
which, however, caused no marked inconvenience.') 

228 —Compound fracture of the left metacarpal bones and contused 
wound of the head and buttock :— G. Sugiyama, aged 28, a seaman belonging to 
the Akitsiishima, in the naval engagement of the Yellow sea, was carrying shells to 
No. i'l side gun, when a shell exploded against the! shield of that gun, and he was 
wounded by the fragments on tin' head, hand and buttock. On examination, on the 
lefl iide of the occipital region, that is, at a point 5 cm. above and behind the left 
mastoid process, a 5f-shaped contused wound, 5 cm. in length was found, and the scalp 



INJURIES OF THE UPPER EXTREMITY. I55 

and occipito-frontalis were perforated, bnt without injuring the pericranium or the bone. 
On the dorsum of the left hand was found an irregular star-shaped, lacerated wound 3 
cm. in diameter at the ulnar side of the first metacarpus, which broke the 2nd, 3rd 
and 4th metacarpal bones and the exit found its way to the dorsal aspect at the radial 
side of the 5th metacarpus, where it presented a vertical lacerated wound 3 cm. long. 
Bleeding was profuse but not arterial. Another contused wound was seen above and 
behind the great trochanter of the left femur, which was the size of the tip of the little 
finger, 3 cm. in depth but without reaching the bone. Antiseptic dressings were ap- 
plied to the wounds and a splint to the left hand. By a transport bound for home 011 
the 19th, he was taken to the Sasebo Naval Hospital. At the time of admission, the 
wounds of the head and buttock had developed healthy granulation, while that of the 
hand suppurated, and the canal of the wound had an unhealthy granulation and retain- 
ed some pieces of brokeu bone. These foreign bodies were extracted, the part washed 
with carbolic lotion and iodoform gauze applied. On the 28th of the same month, the 
injuries of the head and buttock were healed by granulation. The condition of tin- 
wound of the hand was unfavorable, so on the 30th, under the influence of an ane- 
sthetic, the wound was enlarged, and a vertical incision made on the radial side of the 
metacarpus of the middle finger; the broken ends of the metacarpus of the index-finger 
were sawn away, but as the metacarpus of the middle-finger was smashed, it was 
taken off at the joints above and below ; that of the ring-finger was smashed at its 
lower-end, so this part was separated from the metacarpophalangeal joint, but as the 
upper end of the bone was found intact, the broken end being pointed, was simply 
sawn away. Then the incision of the dorsum was sutured and a drainage tube intro- 
duced. On October 8th, the incision wound of the hand having accomplished the 
primary union, the threads were removed; the entrance and exit wounds on the 
dorsum still discharged a little pus but granulation was healthy. On December 7th, 
the entrance wound healed by granulation ; but the exit still discharged some pus, 
from the sinus leading about 2 c. m. inwards and upwards so the sinus was touched 
with nitrate of silver. On January 24th, 1895, the exit wound at last cicatrized, but 
the removal of the metacarpi of the index, middle and ring fingers caused the loss of 
the functions of those fingers and moreover the movements of the thumb and little 
finger were greatly impaired. Thus disabled, he was, on March 16th, dismissed from 
the service for life, and pensioned according to the regulations. 



156 INJURIES OF THE UPPER EXTREMITY. 

229.— Compound fracture of the right hand, perforating wound of the 
scalp, blind wounds of the upper and fore-arm and contused wounds of the 
shoulder and upper lip : — T. Ibo. aged 24, a stoker of the Akagi, in the battle of the 
Yellow sea, was working in the fore part of the lower (leek as a fire-brigade, when an 
enemy's shell exploded on the upper deck and some of the shell-fragments injured 
both arms and the face. On examination, on the right shoulder was found an oval 
wound 5 cm. in diameter and 1.3 cm. in depth. A part of the deltoid muscle was 
torn away causing hemorrhage. Over the insertion of the pectralis major on the inner 
side of the right humerus was a square wound 1 cm. across and 1.5 cm. in depth 
having an upward direction, at the bottom of which something hard was felt. On 
the ulnar side of tbe back of the right hand was au entrance wound 2.5 c m. long 
and 1.3 c m. wide with an exit on the same side of the palm which had broken the 
5th metacarpus to pieces. On the back of the middle of the left fore-arm, and on the 
ulnar side of the back of the wrist were found irregular square wounds each 1.5 c. m. 
in diameter, and the margins were sharply cut ; the depth was not great, and at the 
bottom of each wound small shell-fragments were lodged. Neither wound had injured 
tlii bones nor the joint. On the part below and to the left of the occipital protuber- 
ance were two small wounds 3 cm. apart, which communicated under the scalp, 
but the bone was intact. From the middle of the upper lip running to the left and 
downwards, was found a lacerated wound 1.6 c m. long, 3 m. m. wide and causing 
the flap to drop. Bleeding was stopped by the torsions and ligature of the vessels. 
1 in ano sthetic, the shell-fragments were extracted from the wounds of the right 

upper arm and the left fore-arm. The one taken out of the wound of the right upper 
arm was of an irregular flattened shape 1.5 c in. in diameter, while those from the 
f ire-arm were half the size of it 

a. Shell-fragment extracted from the right upper arm. 

b. „ ,, „ ,, left f ire-arm. 

c. „ ,, „ „ the hall of the left little linger. 

(see figure No. 10.) The wounds were managed under strict antiseptic treatment, the 
clean margins of the wounds on the left forearm and the upper 
lip were sutured. On the 19th, the patient was sent t 

o Naval Hospital, where all the wounds were found to 

bi inclined ;>' suppurate; as even tbe wounds of the left 

irm an 1 upper lip afforded no hope of union, the threads 





INJURIES OF THE UPPER EXTREMITY. I57 

were removed. From the perforating wound of the right 

hand broken pieces of bone were extracted, a drainage 

tube introduced and a splint put on. On October 21st, the 

Pig. 10. (a) Fragment wounds of the occipital region and the upper lip had healed, 
of shell extracted from the 

right upper arm : (b) that The other wounds became filled with granulation. On the 
from the left forearm : (c) 

that from the ball of the 2Sth of the same month, the patient was transferred to 
left little finger. . 

the Knre Naval Hospital. At this time, the wound of the 

shoulder had contracted to the size of 3 cm. in diameter. The perforating wound of 
the right hand had left only a slender wound with healthy granulation. Bat with regard 
to the wounds of the middle of the left fore-arm, the back of the wrist and the right 
upper arm the granulation was of a dull character presenting an edematous condi- 
tion. So the unhealthy granulation was scraped off, iodoform was sprinkled on and 
carbolic gauze applied. On November Sth, the wounds of the right upper arm, the 
left hand and forearm were all cured. The patient complained of a pain at the ball 
of the left little finger where, on examination, something hard was felt. Cutting 
it open, a square shaped fragment of shell 1 cm. in diameter was obtained (c. in figure 
10). This was perhaps one that had entered by the wound on the back of the wrist- 
joint. On November loth, the incised wound on the ball of the little finger was 
cared by the first union. On the '25th of the same month, the wound on the left 
wrist cicatrized. Now, therefore, tbe only wound remaining was that of the right 
shoulder, and the granulation becoming relaxed, and ansemic symptoms accruing, 
healing seemed to have A mixture of quinine and iron was administered 

internally, as the general strength of the patient seemed greatly weakened. Then 
the nutrition of the body returned by degrees and the wound of I llder was 

cured, by January 31st, 1S95, by forming cicatrix, but owing to the lesion of the 
deltoid and its adhesion to the skin, the movements of the right shoulder became 
hindered the function of the right little finger also was not perfect. Moreover, the 
left upper extremity was generally emaciated, so that the grasping power was greatly 
led. Tims disabled, he was dismissed from the service for life, and on February 
9th left the hospital, and pensioned according to the regulations. 

230.— Lacerated wounds of the right and left hands, the head and 
blind Wound of the left leg : — Y. Eanayama, aged 27, one of guncrew of 
the Fnso, in tiie course of the battle of the Yellow sea, was resting on the lar- 
board side of the funnel casing, having been ordered to stop firing, when a hostile 



158 INJURIES OF THE UPPER EXTREMITY. 

shell pierced through the lower part of the funnel anil broke it to pieces, and some of 
the broken fragments mutilated his right hand, except the ulnar side, and the little 
finger, and exposed the lower end of the radius ; the skin, muscles and tendons about 
the wrist were lacerated and attended by hemorrhage. Also on the left side of the 
occipital region was found a lacerated wound 2.5 cm. in vertical and 1 cm. in 
transverse diameter and another one 2 c m. in vertical and 1 c m. in transverse 
diameters on the ball of the left little finger, and a third of 2 c m. on the inner side 
of the left leg, in which an irregular iron fragment 2 cm. long and 1.5 cm. wide 
was felt and extracted. After stopping the hemorrhage of each wound, antiseptic 
bandages were applied, and the patient was kept perfectly quiet. On the 18th next, 
the right fore-aim was amputated at its lower third by circular incision; the skin flap 
was then sutured, and dressed antiseptically. On the 19th, the temperature was 
normal, and the same day lie was taken on board a transport, and admitted to the 
Sasebo Naval Hospital on the 21st. At the time, the wounds of the occipital region, 
the ball of the left little finger and the left leg were suppurating owing to the bruise 
of their margins. Asa part of the stump of the fore-arm began to suppurate the 
threads were removed and a drainage-tube introduced, and all the wounds were strictly 
managed antiseptically, and progress was favourable. By the end of October, only a 
small granulating surface remained on the stump, all the other wounds had cicatrized. 
On the 28th, he was transferred to the Kure Naval Hospital. On February 18th, 
the granulating surface of the stump had healed by scabbing. On the 26th, a certif- 
icate of his inability for service was forwarded to the admiralty, the artificial limb 
which Her Majesty the Empress was pleased to grant him was given him and he 
was discharged from the service for life ; with regular pension. 

(G) INJUEIES OF THE FINGER 

231.— Abrasion of the right index and middle fingers : — T. Goto, aged 
24, a seaman of the Saikyo-maru, in the engagement of the Yellow sea. was tiring the 
■17 in. in. 0. F. gnu on the starboard side in the fore part of the upper deck, when a 
hostile shell came from the starboard and broke off the derrick of tie- fore-mast. < me 
of the broken wooden splinters wounded him on tin 1 right fingers. On examination, on 
the back of the right index and middle fingers were found abrased wounds with slight 
hemorrhage but without any lesion of bones. Carbolic gauze was applied. On the 
20th of the same month, they had healed by scabbing. 



INJURIES OF THE UPPER EXTREMITY. I59 

232— Abrasion of the right index finger :— I. Takuma, aged 20, one 

of the gnu-crew of the Fuso, in the course of the battle of the Yellow sea, was 
resting on the larboard side of the funnel-casing, when an enemy's shell struck the 
funnel and broke it into pieces. One of the broken fragments of iron inflicted an 
abrased wound on the back of the terminal joint of the right index finger, peeling the 
nail and skin away. The wound was sealed with sublimate gauze and he resumed 
work directly. The wound had healed on October 4th. 

---—Contused wound of the right index finger:— J. Shiuowara, 
aged 28, one of the gun-crew of the Akagi, in the battle of the Yellow sea, was firing 
the larboard No. 6 Q. F. gun on the stern of the upper deck, when a hostile shell broke 
the starboard side of the stern. The broken pieces of iron were driven about, and 
some of them wounded him on the right index finger. On examination, there was 
found a lacerated wound running from the ulnar side of the base of the right index- 
finger, along the back of the finger to the upper part of the 2nd joint ; at the bottom 
of it, the extensor tendon was exposed and luemorrhage was profuse, on the palmar 
surface of the 1st joint of the same finger there was a contused wound of a square form 
1.5 cm. across, the margins were irregular, and everted; these two wounds seemed 
to be the entrance and exit wounds of the same injury, but they did not communicate 
with each other, no foreign body was found nor any lesion of bone. The blood 
vessels were ligatured and an antiseptic bandage applied. On the 19th, the patien, 
was sent to the Sasebo Naval Hospital. After admission, progress was favourablet 
and on the 31st of the same month, both wounds filled with granulation so as to 
become level with the skin. On this day, he was transferred to the Kure Naval 
Hospital. On October 24th, cicatrix formed, and he returned to duty perfectly le- 
covered. 

234.— Contused wound of the right middle finger with tmrns of the 
left upper arm : — -S. Kobayashi, aged 31, one of the gun-crew of the Hashidate, 
in the course of the engagement in the Yellow sea, was in the fort of the bow gun in 
the fore-part of the upper deck, when a hostile shell burst, striking the inner wall of 
the shield of the gun. At the moment, by some of the shell-fragments he was in- 
flicted with a contused wound on the 2nd joint of the right middle finger, and au 
abrasion the size of a pin-head in the lower margin of the right cornea. Beside?, by 
the flame of the explosion, burns of the 1st and 2nd degrees were sustained in the 
lower part of the left upper arm down to the tips of the fingers. Temporary relief 



ICQ INJURIES OF THE UPPER EXTREMITY 

was directly given on board, and ou the 21st, the patient was admitted to the Saseho 
Naval Hospital. Then atropine was dropped into the injured eye and a compress of 
boracic lotion applied. Antiseptic bandages were applied to the lacerated wound and 
burns. On October lltli, the lesion of the eye and burns of the left upper arm 
were healed, but with the lacerated wound of the right middle finger there was still 
pus discharge, and granulation was unhealthy, and the joint became inflamed. A wet 
carbolic compress was applied to the inflamed joint. On November the 8th, the 
wound of the middle finger was healed by scabbing : the inflammation of the joint 
had also subsided, but the flexion of the joint was not satisfactory, so local bathing 
ami active movement were ordered. On November the 22nd, the patient had per- 
fectly recovered and returned to duty. 

235.— Contused wounds of the left fingers, and left side ol the chest: 

— K. Matsuo, aged 29, a seaman of the Akagi, in the engagement of the Yellow sea, 
was engaged in firing on the fore-top, when a hostile shell came to the top and burst 
there. At the moment by the shell-fragments, he was wounded in the chest, left 
hand and leg, and was stunned by the concussion. Ho was immediately lowered 
from the top and carried to the surgery where he was first given a draught of brandy 
to revive him. Then on examination, circular wounds, respectively 6 m. m. were 
found located in the 1st phalanges of the left middle and ring fingers ; the bottoms 
reached the bones, but without incurring any lesion to the periosteum nor to flic 
bones. The borders of the wounds had numberless black spots owing to the penetra- 
tion of powder grains. Again on the left side of the chest were two abrased wounds ; 
and on the inner side at the upper third of the left leg, an abrased wound was 
noticed. Sublimate gauze, to the wounds was applied and being taken on board a 
transport on the 19th, the patient was delivered to tin' Sasebo Naval Hospital on the 
21st. Progress was favorable and by the 30th of the same month, the wounds of the 
fingers and chest healed, but the action of the injured lingers was not perfect especi- 
ally the flexion ; also the wound of flic left leg still remained. The same 'lay he was 
transferred to the Kure Naval Hospital. Now the power of the injured fingers was 
ei lually returning, and the wound of the left leg improving, he left the hospital on 
( (ctober 24tb to return to sen ice, 

•-^'•>.— Contused wound of the left fingers:— K- Miyata, aged 21, a car- 
penter of the Yosbino, in the course of the Yellow sea battle, a hostile shell hit the 
starboard side in the fore part, that is, the cuter wall of the coal-bunker and exploded 



INJURIES OF THE UPPER EXTREMITY. \Ql 

breaking the outer plating of the ship's side. To repair the hole made on the outer 
plating, be was out on the ship's side, when by the sharp edges of the hole, he in- 
flicted wounds on the hand and fingers. On examination, shallow contused wounds 
on the palmar aspects of the 2nd phalanges of the thumb, middle and ring fingers 
were discovered with slight hemorrhage. Sublimate gauze was applied. On the 
21st of the same month, they healed under scabs. 

237.— Lacerated wound of the right thumb :— H. Hayakawa, aged 2G, a 
stoker belonging to the Hiyei, in the naval engagement of the Yellow sea, was posted 
as a member of the fire-brigade, and was working ; as a temporary assistant to a shell 
carrier, in the 4th division of the lower deck when a hostile shell exploded in the 
ward-room of the 5th division. At that moment, he received a lacerated wound oil 
the right thumb by one of the flying wooden splinters. After being temporarily 
dressed on board the ship, the patient was sent to the Sasebo Naval Hospital and ad- 
mitted on the 21st of the same mouth. The condition of the wounds, was this ; on 
the ulnar side of the ungual phalanx of the right thumb was found a vertically 
lacerated wound 2 cm. in length and 1 cm. in depth but not reaching the bone, 
besides, the nail of the left great toe was stripped off. The patient perfectly recovered 
on October 1st and returned to the service. 

288.— Lacerated wound of the left thumb : — M. Okura, aged 20, a stoker 
on board the Hiyei, in the engagement of the Yellow sea, was posted as a member of 
the fire-brigade, and was temporarily assisting to carry shells. When he was passing 
the 4th section of the lower deck, a hostile shell exploded in the ward-room of the 
5th section, and he was wounded on the left thumb by one of the flying shell frag- 
ments. Simple dressing was used on board, and on the 21st following he was con- 
veyed to the Sasebo Naval Hospital. Condition of the wound : — On the ulnar side of 
the left thumb was found a vertically lacerated wound, the margins of which were 
torn raggedly, and which was 3 cm. long and 1 cm. in depth, but not reaching the 
bone. Under the use of an antiseptic bandage, it healed by granulation. He 
left the hospital completely cured on October 19th to resume his duties. 

239.— Simple fracture of the right thumb :— U. Shibuya, aged 30, one of 
a torpedo crew of the Hiyei, at about 11.30 a.m. September 17th, 1894, just before 
the commencement of the battle of the Yellow sea, while assisting in conveying a 
torpedo, he slipped down by accident in the fore part of the lower deck. He 
happened to thrust his right thumb against the deck causing a fracture at the middle 



162 IXJUJUES OF THE UPPER EXTREMITY. 

of its first phalanx. On trying to move the thumb, crepitation was felt and severe 
pain. The fracture was a transverse one, its broken ends remaining at their natural 
position without intersecting one another. The thumb was fixed by a splint and he 
directly betook himself to work, but the thumb gradually became swollen and painful 
so that after the battle was over he could not coutiune his work. Therefore he 
was, on the 21st of the same month, admitted to the Sasebo Naval Hospital. There, 
the injured part was fixed by a splint as before, and on October the 12th the fracture 
joined, the splint was removed, and the movements of the thumb were tried, but as 
the grasping power was found imperfect, he was told to exercise its active movements. 
On October 17th, completely healed, he returned to the service. 

240.— Compound fracture of the right index-finger : — T. Kubota, aged 

84, assistant engineer of the Naniwa, in the battle of the Yellow sea, was in the 
engine-room when the heavy stern gun was fired, the shock of the discharge caused 
him to lose his balance and iu putting out his arm to recover himself he had his 
right index-finger seized between the radius-rod of the eccentric and the connecting 
rod of the transmission lever, thus causing a complicated fracture of the 1st phalanx 
of the index-finger and a lacerated wound 5 c. m. long extending from the palmar 
aspect of the root of the index-finger to the palm of the hand. The wound was a gaping 
one with profuse bleeding and the 1st phalanx of the finger was obliquely broken. 
Both ends of the fractured phalanx were replaced and fixed by a splint. Progress 
auspicious. On October 15th, the wound healed leaving a slight derangement of 
motion in the 1st joint of the injured finger. 

241.— Compound fracture of the lefc index-finger and burns of the 
face, neck, back, fore-arms, buttocks and legs :— M. Yosbikawa, aged 24, 
one of the gun-crew of the Matsnshima, in the course of the naval battle of the 
Yellow sea, was in the fort of No. 9 gun on the starboard side in the fore part of the 
lower deck when a 30.5 cm. shell of the enemy burst against the shield of No. 4 side- 
gun on the port side of the same deck. Immediately, ammunition provided for the 
side-guns caught fire and exploded, and he received a compound fracture of the 2nd 
phalanx of the left index-finger by one of the fragments of the shall ; besides, from 

•.plosion flame, burns of the 2nd degree on the face, ears, neck, back, and on the 
back of the fore-arms, left buttock and the lower parts of the legs. To the burns were 
applied oiled lint-, and sublimate gauze t^ the wound of the finger. On the 20th 
the patient was conveyed to I o Naval Hospital. Conditions of wounds: — 



INJURIES OF THE UPPER EXTREMIT5T. \Q3 

The 2nd and 3rd phalanges of the left index-finger were found smashed, the soft 
tissues also destroyed, so that the finger hardly remained connected by a healthy part 
on its ulnar side. With the burned surfaces, the skin was turned black, blisters 
appearing here and there and sloughs at some places; especially the upper part of the 
left ear which was deeply burned. The left index-finger was cut away at the 2nd 
joint, the flap sutured and then covered with sublimate gauze. Cloths wet with a 
boracic solution were applied to the burns. On October 11th, the burns were all cured 
but leaving a loss of tissue in the upper part of the lobe of the left ear. The amputated 
stump of the index-finger partly suppurated, so being cut open was washed with 
carbolic lotion and covered with carbolic gauze. On December 22nd, the amputated 
stump formed cicatrix, but on account of pain in the stump, the injured hand could 
n jt be used, so a protecting baudage was applied. On account of his inability for 
duty owing to the loss of the left index-finger, he was dismissed from the service for 
life and left the hospital on March the 10th, 1895, and is pensioned according to 
the regulations. 

242.— Crushed wound of the right index and middle fingers :— 

S. Okano, aged 22, one of gun-crew of the Takachiho in the battle of the Yellow 
sea, was firing on the fort of No. 4 gun on the port side of the waist-deck, when he 
had the right index and middle fingers seized between the gun-gears. Both fingers 
were crushed away from the base of the 2nd phalanges, and left hanging by a part of 
the flexor tendons. The wounds were ragged and bleeding, the ends of the crushed 
bones protruding. The soft tissues hanging down were cut off, the sharp ends of th, 
bones pared, and haemorrhage checked ; then the wounds were closed with antiseptic 
bandages. The patient was sent back by a transport starting for home on the 19th 
and was admitted to the Sasebo Naval Hospital on the 21st. Some days after, a 
swelling ensued, extending from the injured fingers up to the back of the hand accom- 
panied by a pain which prevented his sleeping ; and the broken ends of the phalanges 
still remained exposing themselves at the wounds, so on the 27th both the index and 
middle fingers were amputated at the distal extremities of the 1st phalanges. The 
margins of the wounds were sutured and antiseptic bandages applied. On October 
2nd, the swelling of the back of the hand and pain entirely disappeared ; the threads 
being cut away, a little serum mixed with blood came out of the stitch-holes but no 
pus was seen. Dry sublimate gauze was applied. On the 4th, the sutured wounds 
accomplished the primary union, and simply a protecting bandage was made use of. 



1(34 INJURIES OF THE LOWER EXTREMITY. 

On the October 30tb, he was dismissed from the service for life having been adjudged 
unfit for duty again, owing to the loss of these two fingers and he left the hospital. 
He is now a pensioner according to the regulations. 

243.— Mutilation of the limbs with burns of whole body :— T. Hisa- 

dami, aged 27, a petty officer on board the Matsushima, in the naval engagement of 
the Yellow sea, was in the neighborhood of the powder magazine in the fore part of 
the lower deck, as the chief officer of the magazine, when a hostile shell burst against 
the shield of No. 4 gun on the port side of the lower deck, and at the same time 
ignited the ammunition provided for the side-guns. By this accident, he was 
burned all over the body, and having all his limbs mutilated, he died on the spot. 

244.— Partial mutilation of the limbs with extensive burns: — M. 

Furuya, aged 27, one of the gun-crew of the Hiyei, in the battle of the Yellow sea, 
was firing the No. 4 gun on the port side, when an enemy's shell flew in over the 
starboard waist netting and burst against the stanchion of the booms ou the port 
side. At the moment, by some of the fragments of shell he sustained terrible vomit Is 
in the upper and lower limbs, mutilating the soft tissues as well as bones. Moreover, 
a flying shell fragment struck the powder case carried by another man and set it on 
fire, thus igniting his clothes which gave him bums over a larger part of his body. 
He died immediately. 

8. INJURIES OF THE LOWER EXTREMITY. 

(A) INJURIES OF THE GLUTEAL AND INGUINAL REGIONS 

245.— Blind wound of the left gluteal region :— T. Hashiguchi, aged 19, 

a cook on board the Takachiho, in the battle of the Yellow sea, was in the gun sup- 
port, turning the fan leading to the magazine, when a hostile shell exploded striking 
the starboard side of the after part. One of the shell-fragments piercing the ship's 
side dashed into that gun support and inflicted on him a lacerated wound of an 
irregular shape. '2 cm. in diameter, and 3 cm. below and behind the great trochanter 
of the left femur. The wound had serrated edges, attended with a slight hemorrhage. 
The wound took a winding course forwards and down-wards between the muscles to 
a depth of 7 cm. On probing no foreign bodi< found. An atiseptic bandage 

was applied. Taken on board a transport bound home on the 19th, the patient was 
admitted to the Sasebo Naval Hospital on the 21st. There was a slight pus dis- 
charge from the wound, but under antiseptic mea in it progressed favorably, and 



INJURIES OF THE LOWER EXTREMITY. 165 

the canal of the wound filled with granulation by degrees, the patient completely 
recovered and left hospital on October 11th. 

•210.— Contused wound of the right inguinal region and blind wound 
of the left le°" : — S- Imagawa, aged 23, a stoker on board the Akitsushiina, in the 
coarse of the battle of the Yellow sea, was going to change the direction of the 
ventilator of the engine-room, by the side of the engine-room hatch in the fore-part, 
when a hostile shell burst against the shield of No. 5 side-gun on the starboard waist 
of the upper deck. He received lacerated wounds by some of the flying shell- 
fragments, on the right inguinal region and on the inner part of the upper 
third of the left leg. On examination, along the inner side of the right spermatic 
cord was found a lacerated wound of the size of the tip of the little finger, attended 
by bleeding. An examination, showed that the wound took a course deeply inwards 
and down-wards towards the scrotum but did not reach the cavity of tunica vaginalis, 
and the spermatic artery escaped the injury, hiemorrhage was not heavy. Also, on 
the inner side of the left tibia below the knee joint, was a blind wound 2 cm. in dia- 
meter ; and a small shell-fragment was lodged, but without giving any lesion to the 
bone ; it was extracted. The wounds being antiseptically dressed, the patient was 
enjoined to strict rest. Some days after, the scrotum became swollen and tense, so 
that it reached 2'J cm. in circumference, attended with pain and subcutaneous 
extravasation. It gave fluctuation to the touch ; urination was normal, and 
the temperature also normal. The scrotum was treated by lead lotion. On 
the 19th, symptoms remained the same, and on the same day he was taken 
mi board a transport and was admitted to the Sasebo Naval Hospital. Condi- 
tions of the wounds: — The inflammatory swelling of the scrotum had spread to 
the perineum, the scrotum was raised by means of a pail and cold applied constantly. 
On the 25th, the scrotum remained still swollen, but pain had greatly decreased. 
On October the 5th, the inflammatory swelling of the scrotum subsided, and the 
testes were found to be swollen also, the extravasation of blood in the scrotum became 
so hardened that it could not be absorbed, so the hair on the scrotum was shaved 
away, and under strict antiseptic precaution, the skin was cut open and a large quan- 
tity of coagulated blood extra vasating between the subcutaneous connective tissues 
was evacuated, followed by the introduction of a drainage tube and the application 
of an antiseptic bandage. On the 10th of the same month, the incised wound of the 
scrotum evacuated only a brownish liquid without suppuration, so the drainage-tube 



1(36 INJURIES OF THE LOWEB EXTREMITY. 

was removed, and antiseptic gauze was filled into it. The wounds on the inguinal and 
tibial regions became small with healthy granulation. On the 25th, the wound of 
the left leg formed cicatrix, and on November the 12th, that of the inguinal region 
accomplished cicatrization leaving au induration there. The swelling of the testes 
had not entirely subsided, and gave much pain to pressure, the incised wound of the 
scrotum not closing yet, some pus escaped from it. By the middle of December, the 
swelling of the testes had nearly disappeared, and the incised wound of the scrotum 
almost healed. On January 12th, 1895, the patient completely recovered and return- 
ed to the service. 

(B) INJUBIES OF THE THIGH. 

217.— Contusion of the right thigh : — Y. Takagi, agad 13, Chief Navigating 
Officer of the Combined Squadron on board the flagship Matsushima, at the time of 
the attack of the eastern forts of Liukung Island, was standing on the fore bridge 
when a hostile shell passed over the said bridge, rebounding from the sea on the port 
bow. On this occasion, by some of the broken wooden splinters caused by the pas- 
sage of the shell, he was struck on the right thigh and mons veneris. The inner side 
of the right thigh was swollen all over and attended by pain, also the mons veneris 
was swollen to the size of a goose-egg. But in neither place did there exist signs of 
subcutaneous extravasations nor injury to the bone. Lead lotion was applied and 
the swelling as well as the pain in both places gradually subsided, and he was 
soon completely cured. 

218.— Contusion of the right thigh with burns of the right leg:— S. 

Nakashima, aged 2G, one of gun-crew of the Yoshino, in the battle of the Yellow sea, 
was standing on the fort of No. 8 3 — pounder on the waist-deck, when a hostile shell 
after piercing through the starboard netting, collided against 12 c. in. shells placed 
in rows along the ship's side and burst with them at once. By one of the flying 
shell-fragments he was struck on the outer-side of the right thigh, and at the same 
turn received a burn on the lower part of the right leg by the explosion gas. On 
examination, the part struck on the thigh was found swollen, presenting a dark purple 
colour; and the burned part of the leg was reddened to the size of the palm. The 

ised part was painted with spirit of camphor, and the burned surface was 
covered with oiled lint. On the 21st of the same month both healed completely. 

21 ( J. Contusion of the left thigh ;— 8. Seto, aged 84, a clerk on board the 



INJURIES OF THE LOWER EXTREMITY. 167 

flagship Matsusbima, iu the naval engagement of the Yellow sea, was posted as a 
carrier of wounded, and brought a wounded man into the petty-officers' room in the 
fore part of the upper deck, and while standing there, a 30,5 c. m. shell burst in the 
fore part of the lower deck, and exploded the ammunition of our side guns. By one of 
the broken pieces of the ship's planks he was struck on the onter-f,ide of the left 
thigh. On examining, the injured part, there was found a slight subcutaneous ex- 
travasation and swelling, and he could only walk with difficulty. Lead lotion was 
applied, and by the 25th of the same month he had perfectly recovered. 

250. — Abrasion of the left thigh : — K. Tateyama, aged 24, a stoker on board 
the Matsusbima iu the Yellow sea battle, was in the engine room, when a hostile 
shell broke the iron plate at the entrance. By one of the iron-pieces he received an 
abrasion in the lower part of the front of the left thigh. A sublimate gauze was applied, 
and on the 20th following, he was conveyed to the Sasebo Naval hospital. At that 
time, in front of the lower third of the left thigh was found a shallow wound 5 c. in. 
long and 4 c. m. wide. The true skin lay bare, and was slightly suppurating, the 
borders of the wound were somewhat swollen with pain. Sublimate gauze was 
applied and progress was auspicious. On October 22nd, the patient completely 
recovered and left the hospital to return to service. 

251. — H. Shimamura, aged 36, Hag lieutenant of the Standing squadron, on 
board the Matsusbima, in the Yellow sea engagement, was standing on the fore 
bridge when a fragment of a hostile shell came and inflicted on him an abrased 
wound 3. 5 c. no. long, and 2.5 c. m. wide, on the outerside of the middle third of 
the left thigh. Sublimate gauze was applied, and the 20tb of the same month the 
wound healed completely under scabs. 

252.— Contused wound of the right thigh and left arm : — A. Imai, aged 
29, a gunner of the Katsuragi in the course of the bombardment of the eastern fort 
of Liukung island, was aiming the bow gun for the enemy's fort, when a hostile 
shell struck the gun-barrel; he fainted from the shock and was unconscious for two or 
three minutes. At the same time, by some of the broken wooden splinters, he received 
a contused wound in the inner side of the upper part of the right thigh ; the skin 
was lacerated and there w r as great pain. Besides, on the inner and front of the 
upper part of the left arm there was a small abrasion with subcutaneous extravasa- 
tion around it. No lesion of bone in either wound was present. In a few days, the 
abrased wound of the upper arm healed, but with that of the thigh, the lacerated skin 



IQH INJURIES OF THE LOWER EXTREMITY. 

bad sloughed and the area enlarged. Under appropriate treatment granulation 
developed but it turned dull, and discharged pus, so that it greatly retarded 
healing. On March the 30th, the unhealthy granulation was scraped away, and 
iodoform sprinkled over. By the end of the month, the granulating surface improved, 
and pus discharge consequently decreased. On April 19th, the wound was complete- 
ly healed. 

253.— Gutter wound of the left thigh: — D. Sato, aged 35, a Landman of 

the flagship Matsushima, in the course of the Yellow sea battle, was acting as a carrier 
(if wounded, and was standing in the tore part of the upper deck when a 30.5 c. m. 
hostile shell burst in the fore part of the lower deck. By one of the fragments 
of shell he received a grooved wound 3 c. m. long and 5 m. m. wide, in the 
lower part of the left thigh, penetrating only the subcutaneous tissue obliquely. He 
was treated on board the ship, and was then transferred to the Hashidate and 
examined on the 30th following : the middle of the injured part developed favorable 
granulation, but the edges still presented grayish colour and discharged pus. By 
the middle of October, the wound developed healthy granulation, pus discharge 
diminished, and on the 24th, the wound became shallow by granulation with no more 
escape of pus. Boracic ointment was applied, and on November the 4th, it healed 

by the formation of cicatrix. 

254.— Blind WOUlld of the right thigh: — H. Ono, aged 27, a senior clerk 
on board the Itsukushima, in the engagement of the Yellow sea, was posted as a shell 
carrier, and was passing by tin: side of the tower of the 32 e. m. gun in the fore part of 
the upper deck, when a hostile shell exploded piercing through the port netting in the 
fore part of the same deck. By some of the shell fragments he received two wounds ; 
a blind Wound in the Upper part of tin- right thigh, just below the outer third of tin' 

Poupart ligament, which was an irregular lacerated wound I. 5 c. ni. diameter, and 

10 e. ni. deep towards the back ; and on the inner side of the middle part of the same 
thigh was a square wound 10 e. in. in diameter, stripped of all the skin. Simple dress- 
ing was applied on board, and he was taken on a transport hound for home on the 
19th, and was admitted on the 21st to the Sasebo Naval Hospital. On examination, 
the wound of the upper part ol the thigh was found to take a course backwards towards 
the posterior inferior spine of the ilium, and to form an abscess there. Therefore that 
part was cut open, ami pus evacuated, also a shell-fragment of an irregular shape 5 c. 
in. long, 2. c. m. wide and 1. 5 c. m. thick' to which a piece of white cloth (part ofhi 




INJURIES OF THE LOWER EXTREMITY. |gg 

linen trousers) was sticking, was 
extracted (see figure 11). On Octo- 
ber, the 28th, the canal of the 
wound was filled with granulation 

Fig. 11. Fragment of the shell extracted from the right a 115 l nls discharge decreased, the 
gluteal region, (a piece of white linen was attached). ^ im]]d m ^ mkM]e of t l le tlligll 

Lad already dried up. On this day, the patient was transferred to the Kure Naval 
Hospital, and progress was so favorable, that on February the 6th, 1895, he was 
completely healed and returned to service. 

255.— Blind wound of the left thigh with crushed right middle finger : 
— I. Matsushima, aged 24, a stoker on bo ml the Hiyei, in the course of the battle of 
Yellow sea. was as a menabei of the fire brigade, standing by the No. 5 pump in tin 
4th division of the lower deck, when an enormous shell of the enemy exploded in the 
ward-room in the fifth division. He received wounds on the right fingers, and left thigh 
from flying shell-fragments. 1 !y this accident all the medical staff on board were killed, 
so his wounds were simply dri ssed by a mate of the ship and he was properly treat' i 
by one of the surgeons from another vessel, when she arrived at the station near Cape 
Choppeki next morning. Conditions of the wounds: — On the ulnar side of the 
ungual phalanx of the right index linger, and at the tip of the right middle finger 
were found lacerated wounds ; the ungual phalanx of the middle finger was crushed, 
and in the tip of the right ring finger there was also a lacerated wound. Again, on the 
inner and posterior part ofthe lift thigh was a blind wound, and an abrased wound 
on the calf of the left leg. Antiseptic dressings were applied to all of them. By 
the transport Genkai-maru bound home, the patient was sent to the Sasebo Naval 
Hospital and admitted on the 21st. On Examination, on the inner and posterior 
side of the upper third of the left thigh, a lacerated wound of the size of the tip of 
the thumb was located, which discharg* d pus. It measured, on probing, 10 c. m. 
in depth running down-wards and inwards in the substance of the adductors, at 
the bottom a foreign body was felt : on being extracted it proved to be an irregular 
plate-shaped shell fragment, 3 c. m. long, 2 c. m. wide, (see the fig. 12.1 and a piece 
of serge. With all the other wounds, granulation developed favorably under 
antiseptic treatment. On the 30th, he was transferred to the Kure Naval Hos- 
pital, and On October the 7th, the abrased wound of the left leg, and the lacerated 
wounds of the right index and ring fingers had healed ; the lacerated surface of the 




170 INJURIES OF THE LOWER EXTREMITY. 

right middle finger became narrow by granulation, but 
the blind wound of the thigh still evacuated pus abun- 
dantly, so a counter opening was made and a drainage 
tube introduced. On the 25th, the wound of the middle 
finger healed completely by cicatrization, and the canal 
of wound in the thigh became somewhat narrower, 

Fig 12 she 1 fragment extracted a discharge decreased. On December the 

from the bottom or the wound 1 ° 

in the left thigh. 18t]l tlic woun( j f tbe thigh became contracted, and 

there was a tendency to pus accumulation ; the temperature rose at times ; so in order 
to facilitate the discharge it was enlarged by an incision. Still the granulation in 
the canal was unhealthy. A mixture of quinine and iron was internally adminis- 
tered, with strict application of antiseptic measures. Time elapsed without much 
change owing to the difficulty of healing the wound in the muscular substance; and 
by June next year, the walls of the canal of the wound indurated, and discharged thin 
pus. There was no prospect of healing the wound so the canal was cut open, and the 
indurated wall was scraped away. After that the granulation improved by degrees, 
and the canal became narrow and on August the 30th healed by a cicatrix 7 c. m. 
long. However, the left thigh became wasted measuring 3. 5 c. in. less in circum- 
ference compared with that of the healthy side. Walking proved difficult owing to the 
pain caused by the stretching of the cicatrized part. As for the right hand, the second 
.ioint of the index finger could not freely be bent or extended on account of the cicatri- 
cial adhesion and the middle finger lost the ungual phalanx, and the ring finger 
also had the second joint ankylosed, so that the grasping power was much weakened 
so as to make him unfit for service. Therefore he was dismissed from the service 
for life on December the 2(Uh and is a pensioner according to the regulations. 

256.— Glancing wound of the right thigh with abrasion of the abdmen : 

— K. Tokunaga, aged 81, a signal-man on board the Akagi in the cours of the Yellow 
sea engagement, was standing on the bridge, when a shell-fragment came living on 
the bridge from the fore part of the starboard side. He was wounded on the right 
thigh. On examination, on the inner and posterior aspect of the upper third of the 
right thigh was found a circular wound 13. 3 c. m. in diameter, in which the muscular 
substance had been deeply torn, so that the adductor inagnus was severed and was 
hanging down. Located behind the above wound was a lacerated lesion of an irregu- 
lar square-form 1.5 c. in. in length, the edges were everted, and at the bottom com- 



INJURIES OF THE LOWER EXTREMITY. m 

municated with the lower part of the former wound ; probably the former was the 
entrance wound while the latter the exit. Fortunately the large vessels escaped injury 
and there occurred no copious haemorrhage. Besides these, there was an abrased 
wound c. m. in diameter, over the right iliac region. To the wounds of the thigh, 
a drainage tube was introduced and they were dressed with antiseptic bandages. On 
the ISth, the dressing was renewed as it had been soiled by exuding blood. The wound 
on the abdomen was inflamed, and the temperature rose to 39. °G C; but no abnormal 
sign in the abdominal cavity was found. The part was covered with a w T et carbolic 
dressing; and the patient was kept in strist repose. On the 19th, the temperature 
lowered a little indicating 38°. 8 C. There were no unfavorable signs in the wounds 
Taken on board a transport, he was admitted to the Sasebo Naval Hospital on the 
21st. At that time, the inflammation of the wound had abated, the temperature had 
lowered to 37°. 5 C; and the wound of the thigh presented a sloughy condition and 
evacuated unhealthy pus. The sloughs were scraped off, followed by the application 
of iodoform, and a wet carbolic gauze. On the 22nd, the temperature fell to nor- 
mal and the wound became somewhat cleaner. By the 30th the sloughs of the 
thigh 'wound had entirely come off, the granulation had improved, and the pus dis- 
charge had diminished, and the abrased wound of the iliac region had almost dried 
up. This day the patient was transferred to the Kure Naval Hospital. On October 
the 8th : the wound of the abdomen healed by scabbing. With that of the thigh, pus 
discharge gradually decreased, accompanied by the development of granulation, so 
that the torn surface and the canal of the wound was filled. On November the 
10th : the wound on the back of the thigh was healed, and that of the inner and 
posterior aspect having almost ceased to discharge pus, granulation developed to the 
level of the skin, however, as, the torn surface was extensive, there was no hope of 
perfectly developing the epithelial covering, so seven small pieces of skin taken 
from the inner side of the left thigh, were grafted. On the 18th, five grafts had 
taken effect while the other two were sloughed. On the 24th, another transplanta- 
tion with seven pieces was tried, and on being examined on the 27th, the seven 
pieces of skin were found ingrafted, since then the epithelium developed gradually in 
a radiant shape from the grafted skin, and the surface of the wound at last became 
remarkably small. The conditions of the wound when examined on January the 
18th, 1895 ; was such that there remained only a shallow wound on the inner and 
posterior aspect of the thigh, boracic ointment was applied to it. On March the Gth, 



17:2 INJURIES OF THE LOWER EXTREMITY. 

the wound had healed with cicatrix, and the patient left the hospital to return to 
si nice. 

257.— Perforating wound of the right thigh with contusion of the 

chest: — N. Tabako, aged 29, one of gun-crew of the Tenryu, in the course of the 
bombardment of the Eastern forts of Linkung Island, was standing under the star- 
board booms on the waist of the upper deck, when a hostile shell exploded striking 
the gun-gear of No. '2 side-gnu on the port side. By one of the shell-fragments, he 
was pierced through the soft tissues from the outer side to the inner of the lower 
third of the right thigh. The eutrauce wound had an irregular triangular shape, 
3 c. m. at base, and ahout 2 c. in. at each side : the exit wound was irregularly 
lacerated in verticil lines being 3 c. in. in length. Out of the exit wound, shell- 
fragments were seon exposing themselves, which being extracted, one was found to 
be 3.(1 c. m. in length, 1 e. m. in width, and the other to he 3 cm. long and 1.5 
c. m. wide (the wound and the fragments are shown in the illustration'). Haemor- 
rhage was slight. Over the 3rd and the 4th ribs in front of the right side of the 

si was found a subcutaneous extravasation about the size of the palm which was 
very swollen and painful, there was also a slight haemoptysis, hut no lesion was 
found of the ribs. The wound of the thigh was washed with carbolic lotion and a 
drainage tube introduced, followed by the application of a sublimate gauze band; 
and to the chest was applied a lead lotion. The patient was to the hospi- 

tal-slip Kobe-mam. At night, cough became frequent, attended by a pain in the 
right side of tli<- chest at deep inspiration. The patient was ordered to keep quiet 
and an anodyne mixture was administered. On the 14th, the wound of the thigh 
suppurated, presenting sloughs at the bottom, so the latter were scraped off. and 
iodoform gauze was applied. Pain in the chest and bloody expectoration still did 
not subside, and a crepitation was heard in the right lung. The former prescrip- 
tion continued. On tin- 20th, he was conveyed to the Sasebo Naval Hospital. 
Examined then, the wounds of the right thigh were found still to communicate with 
each other, and the canal was already beginning to di ealtby grannlal 

with slight pus discharge. Pain in the chest and coughing still existed, but the 
■ration bad ceased, and on physical examination of tl nor- 

mality was found in the lungs, heart, nor pleura. To the wounds of the thigh a 
drainage tube was introduced and they were dressed with carbolic gauze. On March 

Jnd. the canal of the wound on the thigh became narrow and filled with granu- 




N.7ABAK0. LEADING SEAMAN. TENRYU I Jo. 
PERFORATING WOUND OF THE RIGHT THIGH 




INJURIES OF THE LOWER EXTREMITY. 173 

lation, so that the drainage-tube was replaced by gauze. Progress continued favo- 
rable, and on April the 15th, the exit wound on the inner side of the thigh was 
closed by scabbing, followed by the cicatrization of the entrance wound on the outer 
side on the 24th. However, difficulty was experienced in walking on account of 
imperfect flexion of the knee joint. On May the 3rd, tlie patient was transferred to 
the Kure Naval Hospital, where by strict enforcement of bathing, shampooing, and 
active movements of the injured limb, the deranged action of the knee joint was 
gradually restored, so that on the 9th, he was able to flex the knee completely, and 
ou the 17th, he returned to the service perfectly recovered. 

25S.— Compound fracture of the right thigh with contused wound 
of the chest and arm : — Y. NiLongi, aged 22, a stoker of the Hiyei, during the 
naval engagement of the Yellow sea, was working on No. 5 pump in front of the 
accountants' office, in the 4th division of the lower deck, when an enormous shell 
of the enemy exploded in the ward-room of the 5th division ; and by some of the 
driving shell-fragments, he received a compound fracture in the middle of the right 
thigh, where the soft tissues were utterly mutilated and the femoral artery torn off, 
the femur smashed ; and severe contused wounds on the right arm and the right 
side of the chest were sustained. He died on the spot owing to the copious haemor- 
rhage and shock. 

259.— Fracture of the right thigh with abrasion of the left fore- 
arm : — I. Iwamoto, aged 23, one of gun-crew of the Itsukushima, during the battle of 
the Yellow sea, was passing behind the bow-gun in the fore part of the upper deck, 
when a hostile shell exploded, piercing through the port netting of the fore part; he 
was struck by some of the shell-fragments on the right thigh at the juncture of the 
middle and lower thirds, and received a blind wound running from its inner and 
rout aspect to the outer and lower part of the limb. The femur was broken oblique- 
ly at that part. Searching for foreign body a shell-fragment was recognised con- 
cealed under the skin over the blind end of the wound. The skin was cut open and 
an irregular triangular fragment of shell covered with linen was extracted. The 
shell-fragment weighed 18 grammes (See figure 13). And in the upper part of the 
outer side of the left forearm was found an abrased wound of the size of a 5 rin 
copper ; both wounds were directly treated antiseptic-ally, and the fracture of the 
femur fixed with Liston's long outside splint and the patient was, on the 21st, 
conveyed to the Hospital of Sasebo Admiralty. At this time, the wound of the left 




]74 JNJURIES OF T3E LOWER EXTREMITY. 

fore-arm was dried up, but that of the thigh had a 

slight discharge of pus, and on probing the wound there 

were three pieces of bone, which were extracted ; 

then the right thigh was kept extended by weight. 

Progress was auspicious and on November the 6th, 

Fig. 13, Fragment of shell tlle woail( i ] uul aeale( j an d the fracture united. On 
extracted rrora the wound or 

the right thigh ( a piece of December the 10th, walking became normal and he 
linen attached). 

returned to service. 

260.— Compound fracture of the right thigh with contused wound of 
the right shoulder: — A. Yamazaki, aged 23 one of a torpedo crew of the Itsuku- 
shima, during the battle of the Yellow sea, was working in the torpedo-room in the 
fore part, when a hostile shell exploded, striking the torpedo net boom on the ship's 
side, and breaking through it, the fragments of the shell dashed into the said torpedo- 
room. By one of the fragments, he had the light thigh perforated from the front to 
the inner and lower part at the upper third, causing the rupture of the femoral 
vessels, and fracture of the femur (the wound on the anterior part was regarded as the 
entrance of the fragment, and was of an irregular square form, measuring 3 cm. in 
diameter, the other wound appeared to be the exit and was rather smaller having 
the appearance of a rent) ; besides these he received a vertically lacerated wound 
4 c. m. in diameter on the right shoulder. He died on the spot owing to haemorrhage 
and the shock. 

•2('>l.— Compound fracture of the right thigh and the right hand 
with the burns of the lower half of the body :— C. Yoshibayashi, aged 24, a 
cook on board the Hiyei during the engagement of the Yellow sea, was standing on 
the port side in the forepart of the upper deck as a carrier of the wounded, when a 
hostile shell came over the starboard waist netting, and exploded striking the stan- 
chion of the port booms. His right hand was smashed off by one of the shell-frag- 
ments and he was immediately conveyed to the surgery in the ward-room at therear of 
the lower deck, and was undergoing a surgical operation, when a gain a 80.5 C. in. shell 
of the enemy exploded in that very room, and one of the fragments perforated his 
right thigh. By this catastrophe all the medical start' on hoard the ship were lulled, 
so he was compelled then to receive a mere temporary dressing at the hands of 
his comrades, and on tin 1 next morning the ship having dropped anchor at the 
naval station near Cape Choppeki, be was properly treated by surgeons from Other 







3: go 

3 =; 



;s 



i 








INJURIES OF THE LOWER EXTREMITY. 17.3 

vessels. Conditions of the wounds : On the outer and front part of the right thigh, 
at the part 15 cm. below the crest of ilium, was found a large wound of an irregular 
square shape, 13.4 cm. long and 8 cm. wide, and 4 cm. apart from it downward 
arid backward existed another wound almost of the same size. Both wounds com- 
municated with each other beneath the skin which was as it were a bridge ; the 
margins of the wounds were mutilated into a ragged state, and the muscular sub- 
stances were deeply severed, presenting a crater-like shape; the femur was obliquely 
broken below the great trochanter and several pieces of broken bone were found in- 
serted in the muscles. In the neighbourhood of the wound, the right lumbar region, 
the buttocks, back of the left thigh, and the left knee sustained burns of the 2nd 
degree, the right hand was mutilated at the wrist-joint and scarcely hung by the skin 
ami muscles of the ulnar side. Bleeding was not severe from the beginning, and had 
entirely ceased by this time. After proper dressing, the patient was removed 011 
board the transport Geukai-maru. On the 19th, the right fore-arm was amputated 
at its lower third by the circular method, and the flap was sutured. As to the 
broken right femur, its sharp ends were sawed away, and five pieces of broken bone 
were extracted from the wound at the same time, and dressed with sublimate gauze 
and fixed by Liston's long outside splints. To the burns oiled lint was applied. 
On the 21st, the patient was admitted to the Sasebo Naval Hospital. At this time, 
the wounds on the thigh presented a dark grey colour, the skin and muscles were 
sloughed and emitted an offensive smell. The sloughs were scraped off, and iodoform 
sprinkled ; attentions being specially paid to administration of tonics and nutritious 
diets. On the 28th of the same month : the skin spanning between the two wounds 
having sloughed, it was cut off, so that they were turned into a single wound. On 
October the 1st, the burns of the various parts healed, and the stump of the forearm 
performed the first union ; and the granulation in the wound of the thigh grew heal- 
thy emitting no longer an offensive smell. However, the periosteum of the lower 
segment of the broken femur was extensively stripped off, so as to extend almost down 
to the lower third of the thigh; the muscles around the bone had a baglike shape, in 
which pus was accumulating. The temperature rose to 38°C, and the symptoms of 
traumatic delirium set in. Thus conservative measures w T ere hopeless, so on the 
2nd, the thigh was amputated in its upper part, forming lateral flaps. The operation 
was finished in 30 minutes, but the patient soon showed signs of collapse. Im- 
mediately a subcutaneous injection of camphor and ether was administered, and 



1 76 INJURIES OF THE LOWER EXTREMITY. 

brandy internally, besides Lot bottles were applied to the limbs, but lie succumbed 
two hours after the operation. (See tho illustration) 

262.— Mutilation of both thighs :— T. Fujita, aged 32, senior clerk of the 
I liyei, dining the engagement of the Yellow sea, was passing the front of the ac- 
countant's room on the port side of the 4th division, when an enormous shell from the 
enemy exploded in the wardroom of the oth division, he was struck by a large shell- 
fragment, and had his thighs mutilated, and died on the spot owing to heavy haemor- 
rhage and the shock. 

263. — I!. Miyamoto, aged 26, one of gnu-crew on board the Akagi, in the course 
of the battle of the Yellow sea, was filing No. 1 Q. F. gun on the starboard side of the 
bridge, when a hostile shell came in from the after part and burst against the support 
of the said gun. By the shock, he was thrown into the hammock-netting on the 
bridge, and at the same time had both thighs mutilated. He died on the spot the 
result of heavy haemorrhage and a severe concussion. 

-64.— Mutilation of both thighs with contused wound in the right 

temple : — H. Matsumoto, aged 32, one of guncrew of the Tsnkushi, during the bom- 
bardment of Zhih Island, on February 3rd, 1895, was standing by the right side of 
the funnel, when a hostile shell struck him on both thighs and mutilated them in the 
lower third. Also at the junction of the middle and upper third, in front of the 
right thigh was a lacerated wound 5 c. m. long on the surface, and reaching the femur 
in depth. The interior of the wound was large and hollow in form, in which was im- 
beded a piece of broken stanchion 13 cm. long, and 7 c. m. in diameter weighing 
1057.5 grammes, (the figure given here is necessarily smaller than the original being 
a photograph from it). Haemorrhage was heavy. Besides this, on the right temple, 
a contused wound was found which measured 3 c. m. long and reached to the hone ; 
the wound was ragged and gaping; the mind was dull, pulse weak, breathing short ; 
the haemorrhage was stooped and stimulant was given, but at 1.44 p. in. 25 minutes 
afti r the injury, the patient succumbed to the shock. 

265. -Mutilation of the right thigh ;— M. Miyamoto, aged -27, a member of 
the gun-cotton magazine of the Itsukushima, in the engagement of the Yellow sea, 
was working in the torpedo-room in the fore part, when a hostile shell exploded strik- 
ing against the torpedo-uel 1 m ou the ship's side, one of the large fragments enter- 
ed the torpi do-room, and breaking through the ship's side inflicted mutilation of the 



INJURIES OP THE LOWER EXTREMITY. I77 

right thigh at its upper third. He died on the spot owing to heavy haemorrhage and 
the shock. 

266.— Mutilation of the left thigh and right leg;— G- NisMdani, aged 26, 

a petty officer on hoard the Hiyei, in the hattle of the Yellow sea, was carrying the 
■wounded in the upper deck to the ward-room (surgery) in the after part of the lower 
deck, when a 30.5 cm. hostile shell knocked through the starboard side of the stern 
and exploded in the surgery. By one of the shell-fragments, his left thigh and right 
leg were mutilated. He was killed then and there owing to heavy bleeding and the 
shock. 

C INJURIES OF Till-: KNEE. 

267. — Contusion of the right knee : — R- Tanaka, aged 24, one of gun-crew 

of the Yoshino in the course of the bombardment of Liukung Island, on February the 
7th, 1895, was loading the shell of No. 12c. m. gun on the port side amidships, 
when a hostile shell hit the shield of No. G 3 pounder and destroyed it. The broken 
pieces of the shield flew about and crushed No. 2 cutter together with the gear stow- 
ed away in it. lie was struck by one of the wooden splinters on the right knee. A 
palm sized subcutaneous extravasation was present on the outer side of the joint, ac- 
companied by swelling and pain, so that he was unable to walk. However, the joint 
was not injured. A bandage was applied to the part, and he was ordered to k j 
quiet. On the 8th, he was transferred to the hospital ship Kobe-mar u. Examination 
on board the vessel, showed that the swelling was more aggravated than it had been 
the day before, and a wracking pain was complained of at the part on tin' outer sides 
of the knee-joint and the calf. Lead lotion was applied. In due course of time, the 
swelling subsided, and the subcutaneous extravasation was absorbed. On the 20th, the 
patient was conveyed to the Sasebo Naval Hospital. At this time, there still remain- 
ed an induration in the injured part, which gave pain on pressure, but the extravasa- 
tion was nearly absorbed, and the walking was not much interfered with. Spirit 
of camphor was applied and the part was covered by bandage. On March 5th, the 
patient left the hospital completely recovered. 

•-'is.— Contused wound of the right knee and leg :— 0. Saito, aged 23, 

one of a gun-crew on the Yoshino, during the engagement of the Yellow sea, was 
firing the 3 pounder on the starboard quarter-deck, when a hostile shell exploded on 
the said deck after piercing the starboard netting. Some of the shell fragments inflict- 



J 78 INJURIES OF THE LOWER EXTREMITY. 

ed two contused wounds on the right popliteal region ; the upper one was 5 e. m. and 
the lower 2 e. m. in length, both were of subcutaneous depth attended by a slight 
haemorrhage. Also on the calf of right leg a subcutaneous extravasation was present. 
To the contused wounds of the knee sublimate gauze was applied and to the leg wet 
carbolic compress. On the 23rd he was removed on board a transport bound for 
home, and admitted to the Sasebo Naval Hospital on the 26th. At this time, the 
wounds of the popliteal space were slightly suppurating, and pain at the knee-joint 
gave him much difficulty in walking. The swelling and extravasation of the calf 
had not abated yet. The former treatment was continued. On the 30th the 
lower wound of the popliteal region formed scabs, and that day the patient was 
removed to the Kure Naval Hospital. In due course of time the swelling and 
extravasation on the calf subsided and the wounds of the popliteal region were 
healed by the beginning of November. However pain was still felt at the knee-joint 
on walking and, from about the 13th of the same month, a pain was felt at the ankle 
on the same side, with slight swelling after standing a long time. Tincture of iodine 
was painted over the part, and the limb kept in an iron-splint. On the 22nd he left 
the hospital perfectly recovered and returned to duty. 

2(i!i.— Contused wounds of the left knee and scalp with rupture of 
right tympanic membrane : — K. Tawara, aged 35, Chief Surgeon on board the 
Saikyo-marn, in the battle of the Yellow sea, had finished his inspection of the 
preparations for the conveyance of the wounded and was going down the middle 
starboard hatch of the upper cUck, when a 30. 5 c. m. shell entered from the star- 
board beam, pierced through the ward-room on the upper deck, passed about 3 feet from 
him, and exploded on the larboard side of the ward-room about <i feet to his li ft. 
He was struck on the head by some of the scattering fragments of shell and splinters, 
and in addition, owing to the shock of explosion lie was thrown down upon a step of 
the batch, and received contusion of the left knee and rupture of the right tympanic 
membrane: and his uniform was torn like rags. 

Conditions of the wounds: — The injury on the head was a crescent-like 
contused wound, 3 c. m. long, extending over the left temporo-parietal suture. It 
was as deep as the periosteum and attended by a slight haemorrhage, with but 
little pain. In the centre of the left patella a round contused wound, sonic 3 
m. m. in diameter, was found, and by probing a depression on the surface of the bone 
was felt. Haemorrhage and pain were not marked. Iodoform gauze was applied, and 




M. Totoztjmi, Able seaman. 
An example op the artificial leo 
given by Her Majesty the Empress. 



INJURIES OF THE LOWEE EXTREMITY. I79 

the right ear plugged with sterilized cotton, and the Surgeon went on duty again, 
but about 6 p. m., the left knee-joint began to swell and at about 9 p. m. the skin 
around became tense and heated, so that even slight movements could not be perform- 
ed, and the temperature rose to 38°. 5C. The injured limb was put in a back splint 
and a cold solution of carbolic acid was incessantly applied. The wound on the head 
healed in 10 days without suppuration, and the rupture of the tympanic membrane 
in 3 weeks leaving an induration of the membrane and consequent dulness of hearing. 
The inflammation of the knee-joint gradually abated, and the wound contracted 
with a gradual return of movement. Tincture of iodine and bandages were 
applied, and ou the 20th of November, though not fully recovered, he was able to 
resume his duty. 

270.— Compound fracture of the left knee joint with blind wound of 

the shoulder : — M.'. Toyozumi, aged 29, one of the gun-crew of the Fusd, during the 
battle of the Yellow sea, was resting on the left side of the funnel-casing, when a 
shell pierced through the lower part of the funnel, and some of the iron-fragments 
struck the front of his left knee-joint, smashing the patella and the lower end of the 
femur. Some bleeding occurred but the popliteal artery was not injured. There 
was also a blind wound running upwards and outwards from the inner and lower part 
of the left scapula its margins were lacerated, and it measured 13 c. m. in depth 
reaching the posterior surface of the scapula. The bone was not injured. The wounds 
were sealed with antiseptic bandages. The patient's mind was normal, and he com- 
plained only of the pain, so morphine was injected hypodermically and he was ordered 
absolute rest. On the 18th, resection of the knee-joint was performed, and the part 
was kept ou a splint. The blind wound of the scapular region was furnished with a 
counter opening and a drainage-tube was introduced. On the 19th of the same 
mouth the patient was taken on board a transport bound for home and reached the 
Sasebo Naval Hospital on the 21st. On the 22nd the wound of the scapular region 
showed auspicious signs attended with a slight escape of pus while that of the knee- 
joint discharged thin grayish pus, granulation was dull ; a very offensive smell was 
emitted, and the part below the knee joint became cool and numb and as the tip of the 
foot was already turning a purplish color, and the bodily temperature had risen to 38°.7 
C, it became evident that owing to the arrest of the circulation consequent to the 
injury of the popliteal artery, the leg had mortified. Accordingly amputation of the 
thigh at the lower third was performed by the oval method. On the 23rd the tempera- 



IS i INJURIES OF THE LOWER EXTREMITY. 

tare fell to 37°. 6 C. On the 27th the temperature become normal, the canal of the 
wound of the scapular region developed favorable granulation, pus discharge was 
slight, the flap of the stump of the thigh united perfectly and by December 29th the 
wi .und of the scapular region had formed a cicatrix. On January 8th, 1895, the patient 
was transferred to the Kure Naval Hospital and on the 31st a sudden outbreak of 
fever set in and the amputated stump of the thigh presented an erysipelatous 
appearance. Ichthyol collodium was applied over the affected part and on February 
3rd, the erysipelatous patches began to subside; on the 5th the temperature became 
normal, and on the 10th signs of erysipelas were all gone. In April. H. M. the 
Empress graciously conferred on him an artificial limb. On May 10th, he was 
discharged from the service for life and pensioned according to the regulations. (The 
artificial limb is shown in the illustration) 

271 —-Penetrating wound of the right knee joint, and contused wounds 
of head, face and upper limb : — W. Yamanouchi, aged 18, a seaman on the 
Yoshino, in the engagement of the Yellow sea, was passing the after part of the 
upper deck, when a shell pierced through the starboard netting and exploded toge- 
tber with the 12 c. m. shells placed in a row along the side of the ship. He 
sustained a slight burn on the face with grains of powder sticking into the skin, and 
the shell fragments inflicted many wounds : — small contused wounds, one each on 
the forehead, left parietal region and the left temple ; a longitudinally 
lacerated wound over the left malar arch ; three small contused wounds in the back 
of the lower third of the right forearm, an abrased wound on the back of the right 
wrist joint and a longitudinally lacerated wound, 3 c. m. long, between the thumb 
and index finger of the right hand ; and a seriously lacerated wound on the knee- 
joint 5 c. in. long, running laterally just above the patella. The margins were lacerated 
in a serrated form, the quadriceps tendon being partly torn the joint cavity opened 
and the patella displaced downwards : a part of bone sustained fracture, so that the 
articular surface of the femur was exposed. However, both the femur and tibia were 
uninjured. The wound was searched and several tiny pieces o( bone and a shell 
fragment were extracted. The wounds were all treated autiseptically, and the limb 
kept at rest on a splint. The patient was taken on the 19th on board a transport, and 
admitted to the Sasebo Naval Hospital on th< 21st. By that time, the burn of the 

was found already healed, and almost all the other wounds on the head, face and 
arm bad developed granulation without suppuration, lint the wound of the knee- 



V 




INJURIES OF THE LOWER EXTREMITY. \g{ 

joint discharged pus, and Lad a dirty looking surface. The conjunctiva of the left eye 
was also congested attended with pain. On examination a small iron fragment was 
found at the outer part of the conjunctiva and rem >ved directly. On the 22ud, the 
dressing of the knee was changed, pus was discharged copiously, in the evening 
the temperature rose to 3S°C, so a counter-opening was made on the outer and 
inner side, and a drainage tube introduced. On October 3rd the wounds on the head, 
face and the right forearm were healed, and those on the back of the hand had 
become small owing to the development of granulation. The wound of the knee had 
developed granulation, so that the cavity of the joint was closed, the pus discharge 
nearly ceased, and the temperature became normal. On November 9th both wounds 
on the back of the hand were cured, and the wound of the knee had entirely closed. 
As the general health had become somewhat impaired a mixture of quinine and iron 
was administered internally. Progress continued to be favorable, and by February 
20th, 1895 he was entirely healed, but the knee-joint was stiff, so local hot 
bathing and passive exercise were ordered On May 3rd, the patient was transferred 
to the Kure Naval lb ispital, his stiff knee joint found hopeless; and he was dismiss- 
ed from the service for life. He left the hospital, and was pensioned according to 
regulations. (See illustration) 

(D) INJURIES OF THE LEG. 

272.— Contusion of both legs :— H. Tokumarn, aged 24, a petty officer on 
the Fuso, in the course of the bombardment of Zhih Island, was on the step of 
the starboard ladder of the forecastle, when a shell came through the gallant 
forecastle and burst. Some of the flying shell fragments inflicted the following 
injuries : — A contused wound at the middle of the inner side of the right leg, the 
part was somewhat swollen owing to a small subcutaneous extravasation ; at the 
middle of the inner border of the right foot, a contusion some 3 c. m. 
square, with swelling and subcutaneous extravasation ; another small extravasation at 
the lower part of the front of the left leg. As the injured man was unable to walk, 
he was ordered to rest, and the parts were dressed with solution of acetate of lead. 
In due course of time, the abrased surfaces healed, the swellings disappearing at 
the same time. He was perfectly cured on the lath of the same month. 

273. — Contusion of the left leg : — B. Nishioka, aged 30, one of the gun- 
crew belonging to the Yosliiuo, in the attack on the eastern forts of Liukung Island, 



182 INJURIES OF THE LOWER EXTREMITY. 

was standing by the No. 6 12 c. m. gun in the larboard waist, when a shell hit the 
shield of No. G 3 pounder. One of the shield fragments wounded him on the outer 

side of the left leg, causing a subcutaneous extravasation with swelling and pain, 
but without injury to the bone and no hindrance to walking. The injured part was 
dressed with wet carbolic gauze. By the 10th of the same month, the extravasations 
of the parts became absorbed, leaving yellowish patches, and the swelling and pain 
having disappeared, the wound was healed. 

274.— Abrased wounds of both legs :— J. Kodama, aged 26. one of the gun- 
crew of the Fuso, in the battle of the Yellow sea, was firing from the starboard fort 
in the waist of the upper deck, when a shell struck the iron-pillar on the larboard 
side of the upper deck and broke it. Some of the Hying fragments of the shell and 
iron, inflicted several small abrased wounds on the outer sides of the right and left 
legs. Sublimate gauze was applied. On the 2Gth following, the wounds were healed 
by scabbing. 

275.— Abrased Wound of the left leg :— S. Numahata, aged 26, a seaman 
belonging to the Saikyo-maru, in the battle of the Yellow sea, was posted as a crew 
to the -47 m. in. Q. F. gun, on the port bow of the upper deck, and was firing at a 
torpedo-boat, when a shell came from the starboard side and smashed the derrick of 
the fore-mast. One of the wooden splinters inflicted a wound on the right leg. On 
examination, an abrasion of skin 3 c. m. long in the middle of the front of the leg 
was found bat no lesion of the bone. Carbolic gauze was applied, and the wound 
had healed by the 20th following. 

270. — K. Doi, aged 20, a seaman <>n the Tenryu, in the course of the bombard- 
ment of the eastern fort of Liukung Island, was, standing forward of the booms on 
the starboard fore quarter of the upper deck, when a shell from the enemy exploded 
after striking the gear of the No. 2 port gun, and a piece of iron inflicted an abrased 
wound, 3 c. m. across, on the inner side at the lower third of the left leg. The part 
was directly dressed with sublimate gauze. It was perfectly healed on the 19th 
following. 

277— Contused wound of the right leg:— H. Nishikawa, aged 25, one of 
the gnu-crew of the Katsuragi, in the course of the attack on Liukuug Island, was 
-truck by -non wooden splinters produced by a hostile shell ami received a longitudi- 
nally lacerated wound about 3. 5 e. m. long, at the middle of the right call', which 
was found to be as deep as the subcutaneous tissues. The back of the right knee- 



INJURIES OF THE LOWKR EXTREMITY. \Qt 

joint also was somewhat swollen accompanied with pain. The wound was dressed 
with sublimate gauze, and the patient was ordered to rest. To the back of the knee 
lead lotion was applied. By the 26th following, the swelling of the knee had entirely 
subsided, so that he could now walk freely but the lacerated skin of the wound on the 
calf turned grayish black in a sloughing condition, with pus discharge from the 
bottom. The former dressing was replaced by wet carbolic bandage. By March 
10th, the skin had sloughed off, the surface of the wound cleaned and the pus 
discharge ceased. Iodoform was sprinkled on ; and on April 2nd, the wound was 
perfectly healed by cicatrix. 

278.— Contused wound of the left leg : — S. Takarabe, aged 27, a gunner of 
the Tsukushi, in the course of the attack on the eastern forts of Zliih Island, was 
standing behind the machine gun, in the port waist of the upper deck, when a shell 
came from the port side and pierced through the lower part of the funnel. One of the 
iron fragments inflicted a contused wound 3 c. m. long 1 e. m. wide running laterally 
8 c. m. abo%-e and behind the external malleolus of the left leg. The skin and 
muscles were found lacerated, with irregular margins and its depth reached to the 
fibula, attended by profuse haemorrhage. The bleeding was stepped, the foreign body 
extracted, and the wound dressed with sublimate gauze. On the 5th following, the 
patient was taken on board the transport Yedo-maru; and admitted to the Sasebo 
Naval Hospital on the 10th. At the time, the wound was still so deep as to allow 
the insertion of the index-finger which could touch the periosteum of the fibula, there 
was also a great discharge of pus. In March, granulation developed so as to fill the 
wound, and at the end of the mouth the wound cicatrized. But owing to the adhesion of 
the cicatrix to thi fibula, and consequent pressure of the part, the dorsum of the foot 
developed a slight swelling, but without pain. By the use of local hot bathing and 
massage, it gradually subsided, and on May 3rd, he returned to duty, perfectly 
healed. 

27'.'.— Lacerated wound of the right leg with perforated wound of the 
left thigh : — H. Ono, aged 21, a signalman on the Matsushima, in the course of 
the engagement of the Yellow sea, was in the waist of the flying-deck engaged in 
signaling, when a hostile sliell exploded on the said deck. Some of the shell frag- 
ments inflicted a wound with loss of substance on the right calf, and a perforating 
wound at the lower part of the left thigh. Conditions of the wounds : — Both the 
skin and muscles on the back of the right leg, were so mutilated that only the 



184 INJURIES OF THE LOWER EXTREMITY. 

deep muscles were left, the wound was 18 c. m. in the vertical, and 12 c. m. in the 
transverse diameters. However, the posterior tibial artery fortunately escaped 
injury, so haemorrhage was not serious, and no fracture occurred. As to the left 
thigh, there was a lacerated wound 4 c. m. above the knee-joint on the inner side 
of the lower fourth, and some 3 cm. above the knee-cap ; and just in front of this 
wound there was another lacerated one about 3 c. m. in size. They had communicat- 
ed under the skin. Examined at the Sasebo Naval Hospital on the 20th of 
September, the wound of the calf was suppurating, the severed ends of the gastroc- 
nemius presented gangrenous conditions, and pain was so severe that sound sleep 
could not be obtained. The wound was washed with %% solution of carbolic acid, 
and bandaged, a dose of morphine powder was given, and the bandage was changed 
daily. By the 25th, the pieces of flesh in the wound on the calf had nearly all 
sloughed off, so that the part became somewhat clean, yet the pus discharge was 
still copious and attended with pain. A mixture of brandy and an infusion of cin- 
chona bark was administered internally. On the 28th, the temperature rose a 
little, and the patient complained of headache and a dull pain all over the body. 
On examination the wound was found to be progressing favorably, the sloughs having 
all come off and pus discharge greatly decreased. The bandage was changed and a 
dose of quinine was prescribed with an acidulated drink. On October 9th, the 
temperature became normal and the canal of the perforated wound in the lower 
part of the left thigh had filled up and only presented two small granulating surfaces. 
The wound of the calf developed auspicious granulations with but little pus discbarge. 
The bandage was changed every other day, and a mixture of iron and quinine 
administered internally. By November 17th, the wound of the left thigh had healed, 
forming scabs, and that of the calf had contracted so that it cicatrized by January 
15th of next year. The knee-joint on the injured side became ankylosed at an angle 
of about 150°, and the part below that cicatrix was found slightly cedematous 
attended with numbness. This was probably due to the pressure caused by the 
contraction of the cicatrix. Local hot bathing, friction with spirit of camphor, and 
massage were pcrseveringly carried on. Though the oedema gradually subsided, 
the injured limb became much emaciated and the numbness was not perfectly cured, 
and, on standing, pain was felt in the affected limb, so that the patient could not walk 
without a stick. On April 19tb, he was dismissed from service for lite and pensioned 
according to the regulations. 




\ 



I 




R. WAKITA. ABLE SEAMAN." MATSUSHIMA'. I. J.S. 
PERFORATING WOUND OF THE RIGHT LE6. 




INJURIES OF THE LOWER EXTREMITY. J&5 

280.— Blind wound of the right leg with abrased wound of the left 

leg ; — M. Shimizu, aged 18, a stoker ou the Itsukusliima, in the battle of the 

Yellow sea, was in the after boiler-room, when a shell pierced through the coal 

bunker in the starboard waist, and exploded against the ladder set at the middle 

step of the said room. Some of the shell-fragments inflicted a blind wound on the 

outer and back part of the right calf. It was a vertical 

lacerated wound 3 c. m. in length, and half as large 

across. There was also a small abrased wound in the 

middle of the front of the left leg. The injuries were 

simply dressed on board the- ship, and the patient was 

„. ,, , , . admitted to the Sasebo Naval Hospital on the 21st. The 

feliell Fragment extracted from l 

the wound of the right k-g. woll nd on the calf was then found to measure 9 c. m. in 
depth, and a shell fragment the size of a plum seed was found at the bottom ami 
extracted, (see Fig. 14) A drainage tube was introduced and an antiseptic bandage 
applied. At this time, the abrased wound on the left leg had healed. On the 30th, 
he was t ran s furred to the Knre Naval Hospital where the canal of the wound 
filled with granulation, and a cicatrix formed, by October 20th. He was discharged, 
perfectly cured, on the 24th, and returned t>> sen ice. 

2*1.— Blind wound of the left leg :— T. Nakagawa, aged 36, a signal-man 
on the Akagi, in the engagement of the Yellow sua, was at work on the bridge, 
when a musket ball hit his left leg. On examination a round wound tj m. m. in 
diameter on the inner side at the lower third of the left leg was found. The canal of the 
wound took a forward course with a depth of about 1 c. m. yet not reaching the bone; 
hemorrhage was not severe but there was a good deal of pain. The ball was a 
conical one of 11 m. m. diameter, perhaps a Gatling bullet. The wound was 
dressed antiseptically, and he returned to duty. Next day, when the bandage 
was changed, the margins of the wound were inflamed, the former dressing was 
continued, and on the 20th the inflammation around the wound subsided, progress 
was favorable, and the wound was perfectly healed on October 8th. 

282.— Perforating wound of the right leg ;— B. Wakita, aged 23, a 
member of the torpedo-crew of the Matsnshima, in the battle of the Yellow sea, was 
on duty in the torpedo-room in the starboard waist, when fragments of a 30.5 c. m. 
hostile shell that had burst in the fore part of the lower deck entered the said room 
breaking though the bulkhead. One of the fragments inflicted a perforating wound 



18Q INJURIES OF THE LOWER EXTREMITY. 

on the right leg. (The injured man said about the course of the bullet that it lightly 
touched the left side of the forehead, the tip of the glans penis, pierced the leg from 
the inner to the outer side and at last fell on the deck). Conditions of the wound : — 
On the inner side of the upper fourth of the leg, an irregularly lacerated oval hole 
15 c. m. in diameter was found which went through the calf forming a lacerated exit 
7 c. m. long and 4 c. in. wide on the back of the middle part of the leg. The wound 
was temporarily dressed on board the ship and the patient was admitted to the 
Sasebo Naval Hospital on the 20th. On inspection, a slight haemorrhage was found 
which moistened the bandage, but the bleeding had never been severe. A drainage 
tube was introduced and an antiseptic bandage applied. On October 30th, as the 
canal of the wound had grown narrow by favorable granulation, the drainage tube 
was replaced by carbolic gauze. By November 13th, communication between the 
outer and inner apertures was closed owing to the union of the middle part of the 
canal. On February 20th, a cicatrix formed. Afterwards, owing to the contraction 
of the cicatrix, the dorsum of the foot mi the injured side swelled slightly, and thei'e 
was some pain at the cicatrized part. Warm bathing, friction with spirit of camphor 
and massage wen' resorted to, and, by the middle of March, the swelling and pain of 
the leg entirely disappeared, and the patient could walk easily. On the 14th of the 
same mouth, he was, completely recovered and returned to service. (See the illustra- 
tion). 

283. — F. Haruki, aged 25, one of a gun-crew on the Yoshino, in the course of 
the bombardment of the eastern forts of Linkung Island, was standing by No. C 12 
c. m. gun in the port side amidships, when a shell hit the shield of No. G 3 pounder. 
One of the fragments of the broken shield, inflicted a perforating wound at the part 
between the upper and middle third. The wound on the inner and back part was 
irregularly lacerated in a crescent-like form measuring 3. 3 c. m. long and 2. 7 c. 
m. wide, and that on the outer side was of an oval shape G c. m. in length and 5 c. m. 
in breadth. It seemed that the one on the outer side was the entrance and the inner 
tin- exit. On examining the wounds, no important structures were injured. A 
drainage tube was introduced, a corrosive gauze applied and the patient was ordered 
to keep quiet. At night he complained of severe pain, which was alleviated with a 
dose of morphine. Temperature was 37°. 8 C; next morning, the dressing was 
snaked with bloody serum, which was accordingly changed. The same day he was 
removed to the hospital ship Kobe-mam. On the 10th, the lacerated portions of the 












IT 




■■■■■. * 




F.HARUKI. ABLE SEAMAN YOSHINO I _ S. 
PERFORATING WOUNO OF THE RiSHT LEG. 



INJURIES OF THE LOWER EXTREMITY. 1ST 

skin and muscles at the wonnd-apertnres sloughed, and pas escaped ont of the canal, 
the temperature fluctuating at 38°. 5 C. The dressing was daily renewed, and the 
patient was on the 20th admitted to the Sasebo Naval Hospital. Examined at the 
hospital, the sloughs having almost entirely come off, the margins of the wounds 
were found to be clean ; but the apertures of the wound had become somewhat larger 
than they had been at the time of injury, and pus was discharged from both apertures. 
The wounds were washed with solution of carbolic acid, a drainage tube introduced, 
and an iodoform bandage applied. On the 28th, the pus discharge decreased, and 
healthy granulation developed: the canal became gradually narrower, so the 
drainage-tube was replaced by gauze. By March 10th, the canal filled with 
granulation and the communication between the entran/e and exit wounds was 
closed. Oil April 2nd, the wound on the inner side of the leg formed scabs, while 
that on the outer still retained a very small granulating surface. Nutrition of the 
body was somewhat impaired and slight symptoms of anaemia set in, so a mixture 
of quinine and iron was internally given. By May 3rd, the wound was almost 
healed, but on walking, a pain of a stretching nature was felt in the leg. This day 
the patient was transferred to the Kure Naval Hospital. Progress continued 
favorable, and the patient left the hospital on June lGth, completely recovered, and 
returned to service. 

284.— Simple fracture of the right fibula with contusion of the right 
forearm : — M. Ogasawara, aged 21, a seaman belonging to the Hiyei in the course 
of the engagement of the Yellow sea, was standing at the post of relieving tackle in 
the cabin on the lower deck, when an enormous shell exploded in the next ward- 
room, and smashed the partition of the said room and the deck. He was struck by 
some of the scattered wooden splinters and received contused wounds on the right 
forearm and hand, and on the outer side of the right leg. As all the medical staff 
on board the ship were killed by the same explosion, he was temporarily dressed 
by his comrades, and was properly treated by a surgeon from another ship the 
next morning, when the vessel arrived at the rendezvous near Cape Choppeki. On 
examination, on the outer side of the upper third cf the right leg, was found a 
subcutaneous extravasation, where it was somewhat swollen, aud gave severe pain, 
especially in the deeper part on pressure. Crepitation felt at the neck of the fibula 
eviuced the fracture of that bone. Also there existed pain aud slight swelling at 
the outer side of the middle of the right forearm, and at the roots and backs of the 



188 INJURIES OP THE LOWER EXTREMITY. 

middle and ring fingers, though without any lesion of the hone. A splint was applied 
to the right leg, spirit of camphor to the contused wounds on the forearm and hand, 
and the patient was ordered to keep quiet. On the 26th, he was admitted to the 
Sasebo Naval Hospital. At the time, the contused parts of the forearm and hand 
were found to be healing gradually, but as the swelling over the fractured part of the 
leg was still lingering, it was fixed by plaster of Paris bandage. On the 30th, he was 
transferred to the Kure Naval Hospital. Progress was afterwards favourable, the 
fracture of the fibula united, and the pain and swelling disappeared. On October 
25th, the patient was perfectly recovered, and returned to service. 

285. — Contused WOIind of the right leg : — (with superficial lesion of tibia) 
Y. Ilirai, aged 23, one of a gun-crew on the Akitsushima, during the attack on 
Liukung Island, February 7th, 1895, under a command to stop firing, was standing 
just behind the No. 7 gun on the starboard after-quarter of the upper deck, 
when a hostile shell burst on the poop-deck. Some of the shell-fragments inflicted 
two small contused wounds, one just below the tubercle of the right tibia and the 
other in front of the middle part of the right leg. The upper one though piercing the 
periosteum and reaching the bone did not cause fracture. The wounds were 
dressed antiseptically, and the patient was ordered to keep quiet. On the 8th, he 
was removed to the hospital ship Kobe-maru. On the 13th, the wound at the 
middle part of the leg was nearly healed, wdfile the one above it gradually developed 
granulation. On the 20th, the patient was admitted to the Sasebo Naval Hospital. 
The wound continued to discharge a little pus, but under antiseptic treatment 
granulation became healthy and the margins of the wound gradually formed 
epidermis, and a small cicatrix appeared on March 20th, and on the 25th, he left 
the hospital, perfectly recovered, and returned to duty. 

286.— Compound fracture of the right tibia with abrasion of buttock 

and thi°'h : — K. Yotsumoto, aged 24, Midshipman on the Tsukushi during the bom- 
bardment of the forts of Zhih Island, February 3rd, 1895, was stationed, as assistant 
to the lieutenant of the 3rd division, in command of the 9 pounder on the starboard 
fore quarter of the upper deck, when a shell entered from the port side, and pierced 
through the lower part of the funnel. From some of the broken pi< res of the funnel, 
he iei-i ived the following wounds : — A vertically lacerated wound 3 c. m. long, at a 
part 7 c. in. below the knee on the inner side of the right leg, which tore the skin 
and muscles raggedly ; and the wound was gaping. It reached to the tibia causing a 



I 





&y 



JTSUMOTO. MIDSHIPMAN. TSUKUSHI I 
CONTUSED WOUND OF THE RIGHT LEG WITH FISSURES OF THE TIBIA. 




HI TIBU 






INJURIES OF THE LOWER EXTREMITY. IRQ 

longitudinal fissure in its inner surface and attended by haemorrhage. There was 
also a longitudinal abrased wound 3 cm. long on the inner side about the middle of the 
right thigh, and a third, one c. m. long running laterally in the left gluteal region, — 
that is, 5 c. m. backward from the anterior superior spine of the left ilium. Carbolic 
gauzes were applied to the wounds. On the 5th, the patient was placed on board the 
Omi-maru, homeward bound, and on the 10th, reached the Sasebo Naval Hospital. 
Conditions of the wounds : — The margins of the wound on the right leg were 
swollen with the vesicles around, (perhaps owing to the irritation of carbolic acid) ; 
the wound was gaping and there was a slight discharge of pus. The abrased wounds 
on the thigh and gluteal region were already healed. Temperature was 37° C, the 
wound was treated with solution of corrosive sublimate and gauze, and the injured 
limb was kept on an iron splint. On the 14th, in the interior of the wound of the 
leg, free pieces of broken bone were found, which were extracted after enlarging the 
wound, and proved to be two fragments of bone. On the 10th. the swelling around 
the wound had entirely gone, and granulation presented a healthy colour, pus dis- 
charge became slight and the temperature normal. On the 27th, the granulation 
of the wound developed so as to fill the inside and cover the roughened surface 
of the bone. On March 12th, the patient was affected with intestinal catarrh, 
which was, by use of an astringent mixture, cured in a week. The conditions of the 
wound were daily improving, and by the middle of April, the wound had become 
contracted, the granulation developed to the level of the skin and pus discharge en- 
tirely ceased. Boracic ointment was applied. On May 1st cicatrix formed, and on 
the 5th, the patient completely recovered and returned to service. (See the illustra- 
tion). 

287.— Fracture of the left tibia and fibula with abrasion of the back . 

— M. Furubayashi, aged 25, a gunner on board the Akagi, in the battle of the 
Yellow sea, was firing from the starboard fore quarter on the upper deck, when 
fragments of a shell passing under the shield of that gun struck him, inflicting 
a flesh wound near the lower part of the right scapula and on the back of 
the left leg. On examination, there was an oval-shaped abrased wound 3. c. m. in 
diameter, at a part 6 c. m. below the inferior angle of the right scapula ; there was 
no injury to the ribs ; in the middle of the posterior surface of the left leg a lacerated 
wound 3 c. m. long 1.2 c. m. wide, running in an inward and downward direction 
was found. The gastrocnemius was abrased, but as the margins of the wound were 



190 INJURIES OF THE LOWER EXTREMITY. 

acutely cut, haemorrhage was not heavy. An antiseptic bandage was applied. The 
patient was, on the 19th, removed on board a transport and admitted to the Sasebo 
Naval Hospital on the 21st. At that time, the surface of the wound over the lower 
part of the scapula had developed granulation attended by slight discharge of pus, 
while the wound of the calf had begun to suppurate, and the margins were inflamed. 
Carbolic lotion and an iodoform gauze were used. On the 30th, granulation was 
healthy in each wound, pus discharge slight, especially with the injury near the 
lower part of scapula, which had almost dried, and the same day he was transferred to 
the Kure Naval Hospital. The wound of the scapula quickly healed, but the margins 
of the wound on the calf produced vesicles on account of the irritation of the iodoform 
and became ulcerated. Accordingly on October 2nd the part was dusted with dermatol 
and a dry corrosive gauze applied, and after a few days the vesicles dried. On the 
14th, wound on the calf was found to have a canal measuring 6 c. m. in a forward 
and downward direction, out of which bloody-pus was escaping, and a hard body was 
felt at the bottom. By means of forceps a square shell fragment 2 c. m. in diameter 
was extracted. As the fragment had been inserted between the tibia and fibula, the 
shafts of the bones were broken and small fragments of the bones were extracted, a 
drainage-tube introduced and an antiseptic dressing applied. At night the temperature 
rose to 39° C, and pain was felt in the injured part. On the loth, the dressing was 
changed, and all the appearances of tin 1 wound were auspicious. On the 16th, the 
temperature fell to normal and the pain left, but pus discharge was copious, so a 
wet carbolic gauze was applied. On the 25th, the vesicles around the wound were 
healed, the granulating surface became small and shallow ; discharge greatly 
decreased, so the drainage-tube was replaced by gauze. By November 10th, the 
granulation of the wound had grown to the level of the surrounding skin, the epider- 
mis had newly developed along the margins of the wound and there was no 
discharge. Boracic ointment was applied. On the 30th the patient had completely 
recovered and rejoined Ids ship. 

288. -Compound fracture of the right leg with contused wounds of 
the head and thighs and burns of the face :— S. Kato, aged 27. a nurse on 
board the lliyei. in the engagement of the Yellow sea, was assisting in attending 
to the wounded in the surgery near the stern on the lower deck, when a 30. 5 c m 
shell entered after piercing the starboard side, and exploded against the mizzen-mast. 
By some of the shell-fragments, lie sustained injuries on the head, nice and leg- 



INJURIES OF THE LOWER EXTREMITY. IQ1 

As all the medical staff on board the ship were killed at the same moment, lie had 
to be temporarily dressed by his comrades, and was attended to properly by a 
surgeon from another ship, when the vessel arrived at the rendezvous near Cape 
Choppeki next morning. On examination there were : — A lacerated wound 5 cm. 
long reaching the periosteum, running obliquely over the centre of the parietal 
region ; a lacerated wound, one inch in diameter, below the left mastoid process ; a 
round patch of extravasation 5 cm. in diameter in the left temple ; several wounds, 
with loss of substance, in the lower third of the right thigh ; a perforating wound in 
the upper third of the right leg, in which both the tibia and fibula sustained compound 
fractures, involving the knee-joint ; a large, deep wound with loss of substance on the 
left thigh, just above the patella ; the whole face sustained burns and was blackened by 
powder. The wounds were washed witli carbolic lotion followed by antiseptic dressing. 
The lower limbs were put on splints, and the patient was removed to the transport 
Genkai-maru. Jso changes were noticed that day, but on the 19th, the temperature 
rose to 37°. o C, and the dressings were changed. The same day the transport sailed 
for home, and on the 20th, traumatic delirium set in and the patient complained of 
extreme pain, the temperature rose to 89 C, and the right leg became gangrenous, so 
amputation was performed that night, at the middle third of the right thigh. On 
the 21st, the temperature was 38'. 4 O, pulse 106. The mind seemed to be clearer 
than the preceding day, but at about 10 in the forenoon the cerebral symptoms set 
in, and at 11 the patient died. 

289.— Mutilation of both legs and the left forearm :— M. Takenoaohi, 
aged 2.j, one of the torpedo-crew of the Matsushima, in the engagement of the Yellow 
sea, was at work in the middle torpedo-room, when a shell entered through the 
port side and hit him, inflicting mutilated wounds on the left forearm and the 
left and right legs. Haemorrhage was copious. The wounded man was at once 
carried to the forward surgery on the upper deck, as the surgery on the lower deck 
had been destroyed. While he was being attended to, a 80. 5 c m. shell exploded in 
the forepart of the lower deck and the shock of the explosion killed him. 

290.— Mutilation of both legs with blind wound of the right thigh 
and fracture of the nasal bone:— T. Kaneko, aged 41, quarter-master on the 
Tsukushi, in the course of the bombardment of the forts on Zhih Island, was standing 
to starboard of the funnel, when a hostile shell pierced through the lower part of the 
funnel and carried away his right and left legs at the upper parts of the tibia?, 



192 



IX.iriJKS OF THE LOWER EXI'REiin'V. 



Fig. 1 3. Iron pieces extracted from the 
wound of the right thigh. 

(A. B. C. show three pieces which 
were laid layer on layer). 




INJURIES OF THE LOWER EXTREMITY. I93 

liaeiuorrage was profuse. Also on the outer side of the right thigh 3 shell-like iron 
fragments (probably broken pieces of the funnel casing. See figure No. 15) were 
found. Besides, the face had been struck by iron fragments, the bridge of the 
nose was broken and he was bleeding from the mouth and nostrils. He was un- 
conscious, breathing very weak, and pulse faint. Measures were immediately taken 
to stop the bleeding, and injection of ether or various other steps were resorted to, 
but the injured man at length succumbed at 1.40 p.m. the same day. 

291.— Mutilation of the right leg with fracture of both humeri :— M. 

Hashimoto, aged 20, one of a gun-crew on the Fuso, at the battle of the Yellow sea, 
was resting on the port side of the funnel casing, when a shell pierced through 
the lower part of the funnel, and several iron fragments struck his right leg 
and carried it away at its middle part. At the same time lie received compound 
fractures of the upper arms, both humeri being broken to pieces, and bleeding was 
profuse. The face was very pale, pulse weak, and intermittent, and he was in a 
comatose condition. The anterior and posterior tibial arteries were ligatured and the 
wounds on both arms filled with balls of gauze to stop the bleeding, antiseptic dressings 
were applied, and brandy was administered from time to time. In a short time the 
pulse became somewhat stronger, but at 11 p.m., the patient succumbed. 

(E) INJURIES OF THE ANKLE JOINT. 

292.— Contusion of the left ankle :— M. Sbioda, aged 34, clerk of the 
Matsushima, in the engagement of the Yellow sea, was assisting in the surgery on the 
lower deck, but as the surgery was blown to pieces by a hostile shell, he went to the 
surgery in the forepart of the upper deck and was attending to the wounded, when a 
30.5 cm. hostile shell burst in the fore part of the lower deck, and damaged the 
decks and fittings. By one of the scattering splinters he received a contusion on the 
ankle joint, which was bandaged up, and he went on with his duties. Some days 
after, a swelling appeared on the outer-side of the joint, which prevented him from 
walking on account of pain, so constant applications of lead lotion were ordered, and 
by the 30th, the swelling had remarkably subsided ; so tincture of iodine was painted 
on, and a bandage applied. On October 9th, the patient was completely recovered. 

293.— Sprain of the ankle joints with burns of the face and the upper 
limb : — M\ Yamagrtchi, aged 19, a signal-man on board the Matsushima, in the 
engagement of the Yellow sea. was assigned to the post of messenger and was carry- 



194 INJURIES OF THE LOWER EXTREMITY. 

ing orders to the lower deck from the 1st Latch hi the fore part of the upper deck, 
when a 30.5 cm. hostile shell hurst in the fore part of the lower deck and set on fire a 
large amount of ammunition provided for the side gun. The shock of the explosion, 
threw him up and sprained the ankle joints. In addition, the explosion flame caused 
burns of the second degree on the face and forearms down to the fingers. The 
injuries were temporarily dressed on board the ship, and on the 20th the patient was 
admitted to the Saseho Naval Hospital. To the burns wet boracic dressing was 
applied, and the ankle joints were put on splints. The burns progressed favorably 
and healed by October 5th, but the swelling and pain of the ankle joints remained. 
By the middle of December the swelling had gradually subsided, but the pain still 
lingered, and on standing congestion in the injured limb would occur. Chronic 
inflammation of the injured joint set in, which offered no prospect of easy recovery, so 
the patient was discharged from service, June 6th 1895, and pensioned according to 
the regulations. 

294.— Sprain of the right ankle joint :— 8. Seno5, aged 22, a seaman 
belonging to the Kaimon, was on duty as sentinel at an occupied fort of Liucho-tsai, 
Weihaiwei, on February 2nd, 1895, when a hostile shell burst about 2 metres from 
him. The shock threw him down from the 4th barrier on to a shell-wagon and sprain- 
ed the right ankle. The injured part became swollen and painful, and he could 
hardly walk. On the 9th, he was admitted to the 2nd fixed army hospital at 
Kosango, and on the lGth, was transferred to the Hiroshima army hospital. At the 
time, the right ankle joint was much swelled, with pain on flexion and extension. 
A mixture of Lchthyol and iodine was painted on, and the limb was kept at rest. 
On March 10th, he was transferred to the Kure Naval Hospital ; and the swelling of 
the joint had nearly subsided, but was somewhat larger compared with the sound 
one, and walking power was regained. By active movements of the limb and hot 
bathing, he was completely cured, and on the 16th of the same month, returned to 
service. 

295.— Sprain of the left ankle and burns of the right leg :— & Shigeru, 
aged 22, one of a gun-crew of the Matsushima, at battle of the Yellow sea, was 
firing from the No. 7 light Hotchkiss gun, on the starboard side of the flying 
deck, when a hostile shell exploded against the gun-support. By the shock, he was 
thrown down, and the left ankle joint was sprained : the explosion flame also inflicted 
a burn of the 2nd degree on the outer side of the right leg. He also susiained three 



INJURIES OF THE LOWER EXTREMITY. I95 

small lacerated wounds just above the inner malleolus of the right leg. The burned 
part was covered with oiled lint, the lacerated wounds with sublimate gauze, and the 
injured joint fixed with a splint. On the 20th, the patient was taken to the Sasebo 
Naval Hospital. Conditions of the wounds : — The left ankle joint was hot, swollen 
and painful, preventing walking. As regards the burns of the right leg, the epider- 
mis was entirely stripped off, exposing the Malpighian layer, which was slightly 
suppurating. The lacerated wounds of the right foot were already healed. The left 
ankle joint was supported by a splint, and lead lotion applied and the burns were 
dressed daily with wet boracic lint. On the 5th October, the discharge from the 
burns had ceased, and the epidermis had grown in the margins, so the former 
application was replaced by boracic ointment. The pain in the ankle joint had 
greatly subsided, yet the swelling still remained. On the 12th the burns were 
completely healed, and the inflammation of the ankle abated, so mercurial ointment 
was tried. On November 2nd, the swelling of the ankle joint at last subsided and 
no pain was felt on pressure, though walking hurt. Tincture of iodine was painted 
on ; in December, both pain and swelling had nearly disappeared and the patient 
could run freely. On the 30th, he returned to service. 

290.— Simple fracture of the right malleolus with partial dislocation 
of the ankle joint, burns of the face and hands ;— S. Miyashita, aged 30, 
senior nurse of the Hiyei, in the engagement of the Yellow sea, was bandaging a 
wounded man in the surgery, on the lower deck, when a 30.5 cm. shell exploded in 
that room. The explosion flame inflicted burns on the face, forearms, and hands ; 
moreover the shock threw him down on the deck and sprained the right ankle joint. 
The same shell killed all the medical staff on board the vessel, so he was temporarily 
dressed by a comrade and was treated by surgeons from other ships, when the ship 
arrived at the rendezvous near Cape Choppeki next morning. On examination, the 
whole face was blackened by the flame, the forearms and hands sustained burns of 
the 2nd degree, also the right ankle joint was swollen and painful, with subcutaneous 
extravasation. Oiled lint was applied to the burns, and to the ankle joint lead 
lotion. On the same day, the patient was removed on board the transport Genkai- 
maru, and taken to the Sasebo Naval Hospital on the 21st. At this time, the burned 
parts were exposing dermis here and there, the face was covered with black scabs, 
the lobes of the ears suppurating, aud both inembrana tympani were found perforated, 
causing dulness of hearing. As the right ankle was greatly swollen, the exact 



]96 INJURIES OF THE LOWEK EXTREMITY. 

condition of the joint could not be ascertained. On the dorsum of the 4th toe of 
the right foot there was a lacerated wound 2 cm. long. The burned surfaces were 
cleansed with solution of boracic acid, and protected with boracic gauze, the auditory 
meatuses were plugged with antiseptic cotton and the ankle joint was kept in a splint 
and constantly cooled. On the 30th, the burned parts were nearly covered with new 
epidermis, and the wound on the toe had grown healthy granulation, while the 
inflammation of the ankle joint and the rupture of the tympanic membranes pre- 
sented no change. This day the patient was transferred to the Kure Naval 
Hospital. On October 7th. the wound of the toe had healed. The auditory 
meatuses were washed with solution of boracic acid as there was a discharge of pus. 
In course of time, the inflammation of the ankle joint gradually abated, and it was 
found that there was a fracture of the outer malleolus and partial dislocation of the 
joint. The ice-bag was given up, the dislocation was replaced and the part was 
fixed with plaster of Paris bandage. On November 30th, the lacerations of the 
membrana tympani were healed, leaving induration of the membranes and dulness 
of hearing. The inflammation of the ankle joint had nearly disappeared and the 
plaster bandage was removed. As the broken malleolus had not completely united, 
and the restoration of the dislocated joint was not perfect, the sole of the right foot 
was inverted and prevented walking. By December 21st, the injury of the ankle 
joint had healed leaving a slight deformity, and lameness but as his health was 
otherwise quite restored, he left the hospital to return to serv i 

(F) INJURIES OF THE FOOT. 

297.— Contusion of the right foot:— J- Uyeda, aged 3*5, a petty officer of 
the Akagi, during the battle of the Yellow sea, was on duty in the fore part of the 
upper deck, when a fragment of a shell entered from the starboard after quarter, 
passed beneath the shield of No. 3 Q.F. gun in the waist of the upper deck, went 
to the fore part of the same deck, struck the outer side of his left foot and 
inflicted a contused wound. On examination, there was a small swelling on the 
outer side of the dorsum of the left foot, with pain and extravasation under the skin, 
causing difficulty in walking. Lead lotion was applied, and the patient was ordered 
to rest. On the 22nd the swelling gradually abated, and walking became easy. On 
the 26tb, he wa ..red. 

298. — N.Kuril ! il uaut of the Katsuragi, in the < the attack 



INJURIES OF THE LOWER EXTREMITY. I97 

ou the eastern forts of Liukung Island, February 9tb, 1895, while commanding the 
bow-gun, bad bis left foot pressed on by one of the hind wheels in the resoil of the 
gun. On examination, over the dorsum of the 4th and 5th metatarsals of the foot, a 
slight swelling and subcutaneous extravasation were found, with pain, but no 
lesion of bones. Lead lotion was applied and rest ordered. On the 16th, the 
extravasated part broke, producing vesicles. Carbolic gauze was applied, and on 
the 1st of March he had quite recovered. 

299. — Abrasion of the right foot : — I- Oshima, aged 2S, one of a gun-crew 
on the Hasbidate, in the engagement of the Yellow sea, was firing the Hotchkiss 
gun, ou the port fore-quarter on the upper deck, when a hostile shell burst in the 
turret of the bow gun. One of the shell fragments caused an abrasion 1.5 cm. in 
diameter upon the tendo Achillis of the right leg. By the application of corrosive 
gauze the wound healed by scabbing on the 20th. 

800.— Contused wound of the right foot : — M. Takashima, aged 28, 
Lieutenant of the Hiyei, during the battle of the Yellow sea, was, as commander of 
the port battery, passing along the port fore quarter of the upper deck, when a shell 
came over the starboard waist netting and burst against the stanchion of the port 
booms. A small shell fragment struck him just below the inner malleolus of the 
right foot, and caused an irregular round wound 1 cm. in diameter and measuring 
only ru.in. in depth. Corrosive gauze was applied. Ou the 21st, the wound was 
completely healed by first intention. 

801.— Contused wound of the right foot with punctured wound of 
the left leg: — S. Yoshimura, aged 31, a gunner of the Akitsushima, in the 
engagement of the Yellow sea, was inspecting the stern gun, when a shell broke 
the lower part of the shield, then struck, and glanced off the deck. A wooden 
splinter wounded him on the right foot. On examination, there was found a 
lacerated wound betweeu the 3rd and 4th toes running backwards along the sole of 
the foot ; it reached the metatarsals, stripping off the periosteum, and severing the 
small arteries. Another lacerated wound, 6 cm. in length, extended along the outer 
border of the same foot from the root of the little toe. Besides, ou the inner and 
back part of the the left calf there was a lacerated wound caused by a small wooden 
splinter. It was, however, shallow, being only of subcutaneous depth, and the splinter 
was extracted. Haemorrhage was checked, the wounds washed, and antiseptic 
bandage applied. On the 19th, the patient was removed on board a homeward 



198 I XJ TRIES OF THE L' AVER EXTREMITY. 

bemud transport and conveyed to the Sasebo Naval Hospital on the '21st. At that 
time, the foot was swollen and discharged slight pns from the wounds, so it was 
washed with carbolic lotion, corrosive gauze applied, and the injured limb kept 
elevated. By October 1st, the wound on the left calf was healed, the swelling of the 
right foot abated, and the wound tilled with healthy granulation. On the 9th, the 
wound on the outer side of the right foot was healed, and that on the sole had 
grown very shallow, though there was still some discharge of pus. By the 16th; the 
wounds were all healed, but the patient was still kept in the hospital, as walking 
was not perfect, owing to a lingering swelling in the dorsum of the foot, but on the 
24th, he was perfectly recovered, and returned to service. 

302.— Blind WOimd of the right foot ;— M. Kato, aged 20, one of a gun- 
crew of the Hiyei, in the battle of the Yellow sea, was tiling the No. 8 port gun 
on the quarter deck, when an enormous shell exploded in the ward-room at the 
stern of the lower deck, and one of the fragments, bursting out of the sky-light, 
penetrated his leg just above the inner right ankle. He immediately extracted the 
fragment himself. As the same shell killed all the medical staff on hoard the ship, 
he bandaged the wound himself, and was treated next morning by a surgeon from 
another ship, and admitted to the Sasebo Naval Hospital on the 21st. Conditions 
of the wound: — In front of the inner malleolus of the right foot was found a 
lacerated wound 3 cm. long, and 5 cm. deep. It was suppurating slightly and 
touched the bone, which, however, was not injured. Treated antiseptically, it pro- 
gressed favourably. He was, on the 30th, transferred to the Kure Naval Hospital, 
and returned to service on October 24th. 

303.— Blind wound of the right foot with abrasion of the right leg :— 

V. Okamoto, aged 18, a blacksmith on board the Itsukushima. in the battle of the 
Yellow sea, was serving ammunition to the 12 cm. guns. He was going to the 
fore-part of the upper deck, when a hostile shell exploded piercing the forward port 
netting. Some of the fragments inflicted a small blind wound at a part 3 cm. 
below the outer malleolus of the right foot, and a small abrased wound in front 
over the right tibia. Corrosive gauze was applied. On the 20th, the patient was 
admitted to the Sasebo Naval Hospital, and by that time, the wound on the right 
leg had healed, but on probing the canal of the wound of the right foot, a depth 
<'! :S cm. running backwards and upwards with a small fragment at the bottom 



INJURIES OF THE LOWER EXTREMITY. jgy 

was found. The fragment was extracted and antiseptic dressing applied. On 
October 1st, the patient returned to service. 

301. — Compound fracture of the left foot with contused wounds of 
the head, face and thighs : — While B. Sato, aged 24, a seaman belonging to the 
Amagi, was firing upon an enemy's ship from the fort of Liucbo-tsai, Wei-hai-wei, 
on January 30th, 1895, a shell struck the barrel of the gun, and exploded, knocking 
the gun to pieces. Some of the shell-fragments caused several wounds, viz: — A lacerat- 
ed wound over the vertex, 6 cm. long. 1 cm. wide, reaching the pericranium and 
piercing the occipito-frontalis : a lacerated wound 3 cm. long and 1 cm. wide run- 
ning transversely from the right side of the upper lip below the nose, several grains 
of powder also penetrated into the skin of the face ; an oval-shaped lacerated wound, 
12 cm. long and 7 cm. wide, extending from the inner and upper side of the left 
thigh to its posterior part : a lacerated wound, 7 cm. long, on the posterior surface 
of the lower third of the right thigh, compound fracture of the 1st, 2nd and 3rd toes 
of the left foot. The wounds were simply dressed on the spot, and on the 31st the 
wounded man was conveyed to the 2nd field hospital belonging to the 6th Army 
Division. At the hospital, gangrene of the great, 2nd, 3rd and 1th toes of the left 
foot set in, so on the 10th of February amputation by Lisfranc's method was per- 
formed. By the 16th the lacerated wounds on the head and face cicatrized, and 
those of the thighs developed healthy granulation. On the 25th as the stump of 
the left foot had nearly united, the sutures were removed and the foot was dressed 
with iodoform gauze. On the 28th, the patient was transferred to the provisional 
army hospital at Hiroshima. After a time, the wounds of the right and left 
thighs healed by granulation, but the amputated part of the left foot, had formed a 
>inns in its middle, which constantly discharged slight pus. On May'lGth, the 
patient was transferred to the Kure Naval Hospital. At this time, the sinus of the 
foot was 1 cm. in depth, still discharging slight pn>. It was washed with 
carbolic lotion, iodoform sprinkled on, and touched occasionally with nitrate of silver. 
By July 5th, the wound was completely healed, but owing to the loss of the toes of 
his left foot he was lame. However with a protecting bandage, he was ordered to 
take suitable exercise; the general strength gradually returned, and the cicatrix of the 
wound became firm. On October 23rd, he was discharged from service for life, and 
granted a pension according to the regulations. 

305.— Blind wounds of the right foot and thigh :— F. Hioki, aged 25, 



INJURIES OF THE LOWER EXTREMITY. 

one of a gun-crew of the Akitsashima, in the engagement of the Yellow sea, was stand- 
ing behind the No. G Hotchkiss grin, in the port waist of the upper deck, when a shell 
exploded against the shield of No. 5 starboard side-gun. Some of the shell fragments 
inflicted a lacerated wound on the outer and back part in the lower third of the 
right thigh, which measured 5 cm. in depth, and retained a shell-fragment at the 
bottom, which was extracted ; on the dorsum of the right foot, between the 3rd and 
4th toes, was a lacerated wound 2 cm. in length, and 5 cm. in depth, running in- 
wards and backwards, which had broken the 1st and 2nd metatarsal bones. The 
wounds were dressed with antiseptic precautious and the patient was admitted to the 
Sasebo Naval Hospital on the 21st. On the 22nd, the wound on the dorsum of the 
foot was enlarged, the anterior half of the 1st and 2nd metatarsals were cut off, and 
three small shell fragments taken out. Antiseptically treated, progress was favorable. 
On October 30th, tbe wound of the thigh formed cicatrix, and on December 17th, 
that of the foot was closed. Owing, however, to the loss of the anterior half of the 
1st and 2nd metatarsals, walking was imperfect, so he was dismissed from service for 
life and pensioned according to the regulations. 

(G) INJURIES OF THE TOES. 

306.— Contused wound of the right toe :— 0. Hayakawa, aged 22, one of 
a gun-crew of the Hasbidate, in the engagement of the Yellow sea, was working at 
tbe bow-gun, when a well-directed shell burst against the inner wall of tbe shield of 
that gun. One of the shell fragments caused a contused wound on the right 2nd toe, 
1 cm. long, running laterally over the 1st joint reaching to tbe periosteum, but with- 
out injuring the bone. During treatment, inflammation set in in tbe 1st joint, and 
walking became difficult, so tbe patient was, on December 26th, transferred to the 
Enre Naval Hospital. At the time, the injured toe had a granulating surface, aud 
the joint was stiffened, attended by pain. Wet carbolic compress was applied. On 
January 19th, 1895. be returned to service completely cured. 

307.— Contused wound of the left toe ;— T '- Kamei, aged 23, one of a gun- 
crew of the Fuso, during the attack on Zhib Island, February 7th, 1895, was resting 
on the bollard head on the starboard forecastle, when a hostile shell burst, piercing 
the gallant-forecastle. A shell-fragment inflicted a contused wound on the 
2nd toes of the 1. ft foot ; the tip of the great toe was swolli n on account of subcu- 
taneous extravasation and the skin over it was cracked ; the tip of the 2nd toe was 



BURNS. -201 

crushed, exposing the ungual phalanx. The ungual digit of the 2nd toe was cut off 
and the flap sutured up. By the 20th, hoth the flap of the 2nd toe and the skin over 
the tip of the great toe became gangrenous, discharging a foetid fluid, so the stitches 
were removed. On March 19 th, as the granulating surfaces were dull, they were 
touched with nitrate of silver. In June the granulation became healthy, a new skin 
formed around, and on the 17th, cicatrix had completely formed. 



9. -BURNS. 

(A) BUENS OF THE WHOLE BODY, AND OF THE GREATER PART 

OF THE BODY. 

308. — Bums of the whole body : — T. Miura, aged 20, a seaman acting as 
an ammunition tender on the Matsushima, in the battle of the Yellow sea, was 
engaged in lifting ammunition at the entrance of the foreward magazine of the 
lower deck, when a 30.5 cm. shell of the enemy, after striking the shield of No. i 
port-gnu burst, setting on tire the ammunition provided for the gun. The flame 
from the explosion burnt the whole body, and he died before medical relief could be 
afforded. 

309.— Extensive burns covering two-thirds of the surface of the body : 

— D. Ozaki aged 29, a gunner on the Matsushima, during the battle of the Yellow 
sea, was firing No. 2 port-gun in the fore part of the lower deck, when a 30.5 cm. 
shell burst against the shield of No. 4 side-gun. It set on fire the ammunition piled 
near, resulting in an explosion which burned the entire surface of his body except- 
ing the chest, epigastric region, and inner parts of the thighs. The injured man 
was taken to a cabin and oiled lint applied to the burns. He was kept perfectly 
quiet, and brandy administered at intervals. Towards night the pain became intense 
and he complained of terrible thirst. Cold water was given frequently, and a 
stimulant and anodyne were alternately administered. On the morning of the 18th 
he died from collapse. 

The following burns extending over two-thirds of the body were caused by the 
same accident on board the Matsushima ; the conditions of the injured, aud the 



•202 BURN'S. 

treatment pursued was the same, therefore to avoid repetition only their names, 
ages, ranks, and resulting history are given, as an illustration of the terrific havoc 
and loss of life that may result from the explosion of a shell. 

310. — Y. Sekiya, aged 25, member of crew of No, 2 side-gun; died next 
morning. 

311. — T. Hirao, aged 20, member of crew of No. 2 side-gun ; died on the second 
morning. 

312. — S. Nishi, aged 27, gunner of No. 5 side-gun ; died on the third 
morning. 

313. — K. Hata, aged 32, gunner of No. 6 side-gun ; died on the second 
morning. 

314. — S. Tokito, aged 21. member of crew of No. G side-gun; died next 
morning. 

315. — J. Hayashi, aged 32, gunner of No. 8 side-gun ; died on the second 
morning. 

316. — M. Koyanagi, aged 25, member of crew of No. 8 side-gun ; died ou the 
second morning. 

317. — -Y. Hamamotii, aged 25. member of crew of No. 8 side-gun; died on the 
third morning. 

318. — N. Nakama, aged 22, member of crew of No. 8 side-gun ; died on the 
third morning. 

319 — T. Nakada, aged 26, member of crew of No. 10 side-gun; died on the 
second morning. 

320.— T. Inamitsu, aged 20, a seaman actiug as a member of the fore maga- 
zine crew ; died next morning. 

321.— Extensive burns as above with penetrating wound of the 
chest : — K. Oishi, aged 24, midshipman ; died during the afternoon of the next day. 

322.— Extensive burns with contusion of the buttock:— Y. Higo, aged 
21, one of No. 1 side-gun crew : died next morning. 

323.— Extensive burns with compound fracture of the left femur :— 
K. Oka/.aki, aged 27. one of the crew of side-gun No. : died next morning. 

321— Extensive burr.s with compound fracture of squamous portion 
of the left temporal bone :— S. Yamazaki, aged 30, a seamau acting a- a member 
of the fore magazine crew; died next morning. 



BURXS. 203 

325.— Extensive burns with penetrating wound of the sranium:— 
J. Nakoshima, aged 21, a junior bandsman stationed as a bearer of wounded on the 
- quarter of the lower deck ; died next morning. 

32G.— Extensive burns with contused wounds of the left arm : — 
S. Hamauo, aged 25. one of No. 6 side-gun crew ; died nest day. 

327. — Bums : (covering about § of the body) K. Doshimo, aged 30, a gunner of 
the Matsushima, in the engagement of the Yellow sea, was standing by the fi >ri 
of Xo. 7 side-gun on the starboard side in the fore part of the lower deck, when a 
30.5 cm. hostile shell burst against the shield of Xo. 1 side-gun on the port side of 
the same deck, igniting the ammunition provided for the side-gun ; from the explosion 
extensive burns of the 2nd degree were caused, covering the head, face, the whole of 
the left upper limb, right forearm, hand, and the entire surface of both lower extremities. 
The injured man was immediately carried to the cabin and the burnt surface 
dressed with oiled lint, and brandy administered. On the 18th, no marked change ; 
the patient took only a little quantity of condensed milk. On the 19th, the dress- 
ings were renewed ; exhaustion seemed increasing. Brandy and water was given at 
intervals. On the 20th, he was admitted to the Sasebo Naval Hospital, when the 
burned parts presented a bla c with adhering grains of powder and points 

suppuration, while here and there, the true dermis was exposed. As a dressing a solu- 
tion of boracic acid on lint was applied, and the patient given brandy frequently during 
the night, the thermometer showed 37'. 6 C. with distress and sleeplessness. On the 
21st, the temperature rose to 38° C. the mind seemed to be clear except fur occasion- 
al delirium. The dressings were soiled by serous pus and they were changed. In 
the evening he complained of great pain, and doses of opium were given as a hypno- 
tic. On the 22nd, a small quantity of urine was passed for the first time since his 
admission to the hospital. Dress re renewed. The burned epidermis was 

almost exfoliated. That night the t mperature rose to 3d C, and the next morning 
it remained the same : a dose of quinine was given and the dressings changed. In the 
afternoon the thermometer indicated 33. '8 C, delirium was frequent and the dish -- 
intense. At 5 o'clock in ti oon sudden collapse supervened and he died at 

6.30 p.m. (the temperatures given here were taken from the chart after admission 
to the hospital). 

328. — C. Kosugi. aged 28, clerk on board the Matsushima, during the battle 
of the Ye'low sja, was assigned as a carrier of the wounded. At 3. 20 p. m. he was 



•201 



BUEXS. 



Fig. 16. 
Temperature chart of case 3 - 27. 



Fig. 17. 
Temperature chart of case 328. 





^FXPX 


2 K 




P. T.mjmjp. 


ARiFA 


AWJW 


40"- 

39"- 
38°- 
37'- 


















........ 


-■-•-;-— 




■—•?■—- 




----- ! 


— -i 


i— ■ 






\-f- 


..'W 


----: 


U— 


: 




i 




.... lv 




d= 


-—i~- 




.-— r— 1- -r- 







2 S 


2 XI 2 X 


2 X 




Amj?.mjAw.ipm i Ampm 

i ' • i * • ■ * 

...J i_. : 1 : 


AFiJ.li. 


40- 

39° 
38- 

o 

37- 




:.-..::... 


Eg 


i 


:-.:x5 










v 'J. m .. 





























Fig. 18. 
Ti mperature chart of case 3'29. 



20 (\W9fPf * 



All PI AHI. PHI AIM PHI. AlTl PITT W Pill. ATT!. PHI. AI PHI. lit! Pill All! PI M Pill 




R. 



90 100 ion 100 120 101 102 1W 90 95 88 92, 89. 84 80 



30 24122 



BTTRXS. 205 

passing Xo. 9 side-gun in the fore part of tbe lower deck when a 30. o c. ro. shell 
burst setting on fire the ammunition piled near for the use of the side-gun. He 
sustained burns of the 2nd degree on the head, face, the whole of the right upper 
limb, the left forearm, both legs, the whole of the back, and the whole of abdomen, 
his burns thus covering about two thirds of the whole body. He was immediately 
carried to the cabin, and treatment promptly commenced. On the 20th, he was 
admitted to the Sasebo Naval Hospital. At this time — the face was covered with 
black scabs, the hair of the head singed, and the epidermis on the burntd surfaces 
of the abdomen, back, and limbs stripped off, exposing the dermis ; at other points the 
cuticle was raised iuto vesicles with points of suppuration. He w T as restless, his 
mind being alternately clear and then clouded by delirium with moments in 
which he seemed semi-comatous. Temperature 38°. 8 C. The burns were dressed 
antiseptically daily : internally, a sedative was administered. On the 21st, no 
change in symptoms ; the thermometer indicated 38° in the morning and 38°. 
8 in the evening. In the night a small quantity of urine passed ; on the 22nd 
the temperature rose to 39°. 6 C. with increased exhaustion, the mind clear, but 
excited. Stimulants were administered at regular intervals. On the 23rd, at 4 o'clock 
in the afternoon abrupt unconsciousness supervened with chilling of the limbs. Various 
measures for restoration such as hypodermic injection of camphor oil, repeated 
administrations of brandy, hot bottles to the limbs etc., were tried in vain, and at 
4. 30 p. m. the patient died from collapse. (The temperature chart shows the state 
after the admission'). 

329. — K. Ishihara, aged 23, stoker of the Matsushima, during the engagement 
of the Yellow sea, was in charge of the room for the rudder-gear, in the upper part of 
the fore engine room, when, owing to the same explosion, he sustained burns of the 2nd 
and 3rd degrees on the head, face, neck, right shoulder, chest, back, the whole of the 
right upper limb, the left forearm and hand, right lower limb, part of the left thigh 
down to the inner side of the knee, including about two-thirds of the whole body. The 
injured man was directly carried to the cabin, and temporary treatment applied. On 
the 20th, he was admitted to the Sasebo Naval Hospital, at which time the following 
history was elicited : Face partialy denuded of the epidermis: the burns of the upper 
and lower limbs extended into the deep tissues causing a gangrenous state of the soft 
parts. The rest of the burned parts were of the 2nd degree, exposing the dermis. 
Temperature was 38°. 8 O: the general strength had failed, and the patient was 



206 BURNS. 

groaning in anguish. Administration of stimulants was resorted to, the burns were 
dressed with wet boracic lint which was daily changed. On the 25th, the temperature 
suddenly rose to 39°. 7 C. and continued up to the 28th. Exhaustion increased more 
and more, delirium supervened and on the 20th at 5 o'clock p. m. there was a 
sudden loss of consciousness. Death occurred at 7. 30 p. in. (see Fig. 181. 

330. — Burns (covering one-third of the body) — C. Onishi, aged 24, one of 
the gun-crew of the Matsushima, in the battle of the Yellow sea, was engaged in 
the conveyance of cartridges by the No. 10 side-gun, on the port side in the fore part 
of the lower deck, when owing to the same explosion he sustained burns of the 2nd 
and 3rd degree covering one third of the body, viz : — on the head, face, neck, inter- 
scapular region, and both upper and lower limbs.- The left upper and lower limbs 
were affected deeply into the muscles. The injured man was directly carried to the 
cabin and appropriately dressed. On the 20th, the patient was admitted to the 
Sasebo Naval Hospital. Condition of the patient :-— most of the burned parts had 
their epdmrieis stripped off or presented vesicles ; in some parts the whole skin had 
became gangrenous. They were dressed with boracic lint, and brandy was frequent- 
ly given internally. On the 29th, the burns of the left upper arm, the outer side 
of the left thigh, and the left ear, were severely eroded and discharging a great 
deal of pus ; accordingly these parts were washed with a carbolic acid solution. On 
October 9th, a new epidermis appeared over the denuded surfaces of the face and 
right upper arm, while the ears and the left limbs continued to discharge pus. On 
the 14th, the burns of the face, right forearm, and left leg were nearly covered with 
new epidermis, the rest still discharged pus ; exhaustion gradually supervened. On 
the 23rd, the heart became very feeble with faint pulsations, tincture of digitalis was 
given, and as the strength of the pulse continued weak, tincture of strophanthus the 
was substituted on the 30th. On November 13th, the granulation of the burned 
parts improved, and the discharge of pu3 decreased ; the heart's action revived, 
and the strophanthus was withdrawn. Emaciation increased owing to heavy dis- 
charge of pus from the ulcerating surfaces. On December the 20th, the ulcerated 
parts mi the outer side of the left arm and thigh presented dull red granulation, so wet 
carbolic dressings were substituted and daily renewed; followiug this measure the 
granulation greatly improved, while the discharge of pus remarkably decreased. On 
January 19th, 1895, small patches of epidermis developed over the burnt snrfaci 
the lift upper and lower limbs. Tin' ulcerating surface of the right leg measured 28 



2G C 



cz '—3 
-< =D 

X Z 

CO ^ 
CD CV3 



GO Z 
1 = 



V * 



V 





COLLOTYPE. 



l.V K. OGAAVA. 



APPEARANCE OF THE SAME PAT1EXT 
AFTER RECOVERY. 



B CRN'S. -J07 

e. in. ia length and G or 7 c. m. in width with some healthy granulations. Following 
the above treatment, a dressing of lint soaked in horacic acid solution was used and 
iron and quinine given intervally. At intervals the affected parts evacuated large 
qualities of pus, which infecting the newly formed epidermis would retard its growth 
thus constantly checking what otherwise would have heen steady improvement. On 
August the 12th of the same year, the burned parts on the right leg at last were 
perfectly covered with epidermis, and on the 23rd following the burn on the left leg 
was healed. On September the 30th, the burn on the inner side of the left arm was 
covered with epidermis. However, on the outer side of the lower part of the left arm, 
and thigh there were still broad ulcerated surfaces. The same treatment was pursued. 
About July or August of 189G, as the ulcerated surfaces had now no discharge of pus, 
skin grafting was repeatedly performed upon them; and on December 25th of the same 
year all the remaining surfaces of the burns were healed, having been entirely covered 
with epidermis. As has been stated, this case was one of the burns afflicting one-third 
of the body, and took more than two years to recover. He was now extremely emaciat- 
ed and disfigured by ugly cicatrices all over the body : — a cicatrix extending from the 
forehead to the left temporal region with the loss of both external ears ; two or three 
small cicatrices on the back ; as to the left upper limb, a large cicatrix extending 
from the middle of the upper arm to the forearm and hand, as the consequence of the 
cicatricial contraction, the elbow joint was hindered in its movement, so that it could 
only be moved between 45° and 90°; the grasping power of the left fingers was almost 
entirely lost ; as regards the lower extremities the whole of the left gluteal region, 
almost the whole exterior sides of the left thigh and leg, a part of the right gluteal 
region and almost the entire length of the inner side of the right leg presented white 
dotted cicatrices ; both knee-joints crooked at 90°; the feet somewhat inverted, and the 
phalangeal joints partly Hexed and could not be freely moved. Moreover, the extensors 
of the lower limbs being remarkably emaciated, the man could scarcely stand up 
with the help of a stick ; tonics and nutritious measures were especially attended to, 
assisted by hot baths, electricity, shampooing, etc., and thus the general strength was 
regained a little, but the movements of the limbs could not be restored, therefore 
the patient was disch irged, on January 22nd, 1897, from service and pensioned for life 
according to the regulations. (Of the two illustrations produced here, one is a picture 
from life at the time of injury, and the other is a collotype from the photogragh 
taken after recovery). 



BURNS. 

(B) BURNS OF VARIOUS PAETS. 

All cases of bums which do not extend over one-third of the whole body are 
mentione 1 here. 

331.— Burns of the face, neck, left upper and both lower limbs with 
Contused wound of the face : — Y. Mori, aged 24, gunner of No. 5 side-gnu. By 
the same cause as before he received burns of the 2nd degree on the face, neck, the 
left forearm and hand, the outer side of the left thigh and leg, the dorsum of the left 
foot, and the antero-extemal surface of the right thigh and leg. In addition to the 
above, a small contused wound on the right cheek was sustained by a fragment of 
shell. The injured man was carried directly to the surgery in the wardroom, and the 
burns dressed with oiled lint. On the 20th, he was admitted to the Sasebo Naval 
Hospital. Conditions of the wounds at the time of admission: — On several of the 
bnmed surfaces were vesicles, and where complete denuding of the epidermis 
had occurred, pus was discharging. The wound of the right cheek had healthy 
granulation covered with a thin layer of laudable pus. The burns wen' washed with 
boracic lotion and dressed with wet boracic lint. On October 8th, the epidermis was 
perfectly formed on the burnt surfaces of the face, neck, and the right leg ; and the 
wound of the face was healed by scabbing. On the 18th. the burns of the right lower 
limb were healed ; and those of the left lower limb were covered by the new epidermis, 
except on the ankle joint. Those of the left upper limb presented granulating surfaces 
with points of suppuration, this was especially so between the lingers, where the 
injury was deep beneath the skin. On the 30th, the burned surface of the left ankle 
joint was healed, and the granulating surface of the left upper limb had nearly ceased 
to discharge pus ; so boracic ointment was applied in place of the wet lint. On De- 
cember 18th, the burns on the left upper limb were healed by cicatrization, but the 
grasping power was impaired. Local bathing and active exercise of the hand were 
1 c evi red with. On April 9th, 1895, though the flexion of the left ring and little fin- 
was not perfect yet, the grasping power gradually recovered indicating 20 kilog. 
by dynamometer; in this condition he returned to duty, and served for some time. 
In the course of time, cicatricial contraction of the left fingers followed causing 
impairment of movement. Moreover hyperesthesia in the cicatrix supervened, so the 
ping power of the left hand decreased to 1(1 kilog. lie was again admitted on 

Aligns) 9th, and several lie.; I I] as local bathing, massage, etc., were afforded 



BURNS. -20'.) 

but there was no hope of recovery, so he was, on September 5th, invalided and pen- 
sioned for life according to the regulations. 

832.— Burns of the face, neck and both forearms :— S. Obo, aged 20. a 

gunner of No. 9 side-gun by the same cause received burns of the 2nd degree on the 
face, neck, and the parts below the middle of the right and left forearms to the finger- 
ends. The injured man was directly carried to the surgery in the ward-room, and 
dressed with oiled lint. Ou the 20th, he was admitted to the Saseb > Naval Hospital. 
At that time, the hair of the head was found singed ; the face and ear-lobes swollen, 
producing here and there vesicles; the eye-lids, the tip of the nose, forearms and hands 
were denuded of epidermis exposing the dermis. Wet boracic lint was applied at fir.>t 
but as the case improved, it was replaced by boracic ointment. By the middle of 
October the epidermis completely formed over the burns, and healed without 
leaving cicatrices. Oil the 22nd, he returned to service completely red >\ - red. 

333. — Barns of the face, nape of neck, shoulders, upper limbs and left 
leg: — X. Ando, aged 31, gunner of No. 10 side gun, by the same cause received 
burns of the 2nd degree on the face, neck, shoulders, the left elbow, both forearm-, 
left knee and the middle of the left leg. The injured man was directly carried t - I 
surgery in the ward-room, and dressed with oiled lint. Ou the 20th, the patient was 
admitted to the Sasebo Naval Hospital. At the time, the face and ear-lobe-- presented 
a blackish colour, the hair singed, blisters and ulcerations were found on the burnt 
surfaces. Washed with boracic lotion and dressed with wet boracic liut. On October 
28th, all the burns except on the ears were healed. The ear-lobes being deeply at: 
ed, a portion w-as destroyed of each lobe and now presented granulating surfaces. 
Boracic ointment was applied to the ears. On December 21st, he was returned to 
service completely healed. 

334. — Burns of the face, neck, right shoulder, upper arms, and right 
lower limb with blind wound of the left leg : — T. Kurokawa, aged 30, one of X » 
10 side-gun crew, by the same cause sustained burns of the 2nd or 3rd degrees on 
the face, ear-lobes, neck, right shoulder, the right arm to the hand, the left elbow joint 
to the hand, right gluteal region, and the outer side of the right thigh to the knee ; an 1 
a blind wound 2 cm. in diameter at the middle of the left calf. The injured man was 
directly carried to the cabin, and after the administration of brandy, the burns were 
dressed with oiled liut, and the wound of the calf with sublimate gauze. On the 20th, 
he was admitted to the Sasebo Naval Hospital. The face and ear-lobes were covered 



210 BURNS. 

with black scabs, the forehead, neck, right arm, left forearm and the outer side of the 
right thigh were deeply eroded so that the deeper tissues were reached. The wound 
of the left leg measured 5 c. m. in depth and discharged pus. The t smperature was 
37°. 5 C. Burns were washed with boracic lotion and wet boracic lint was applied ; 
and a mixture of bark and brandy administered internally. On the 21st, the tem- 
perature was 88°2., the patient complained of intense thirst and anguish. Dressings 
were daily renewed ; ice was given from time to time. On the '28th, the sloughs at 
several parts having been cast off, red granulating surfaces were exposed. Since the 
preceding day, the temperature returned to the normal degree and the pain much 
lessened. On October 6th, the wound of the left leg healed by cicatrix ; and the burns 
of the face, ear-lobes, neck, shoulder and the left forearm were all healed ; the burns 
of the forehead, right side of the neck, etc., which were deeply eroded developed 
granulations, the areas become narrower by degrees ; the temperature remained 
normal. On the 18th, the forehead and right side of the neck formed cicatrices, and 
there was an inclination to a wry-neck owing to the contraction of cicatrix, so the 
neck was kept straight by means of a paste board splint. Afterwards nearly the whole 
of the burned parts and the wound scar of the left leg formed cicatricial keloid ; con- 
sequently the wry neck towards the right side greatly hindered the movement. The 
right lower eye-lid was everted, and the corner of the mouth drawn towards the right 
and downward, the face became exceedingly ugly studded with scars. The right elbow 
joint could not be extended beyond 120° ; the index, middle and ring fingers on the 
same side were much hindered in the movements. Also the left middle finger stif- 
fened so that it would not be bent at all ; and the ring finger at the 1st phalangeal 
joint, and the little fingers at the metacarpo-phalangeal and at the 1st phangeal 
joints were stiffened at right angle to the palm. The upper limbs wire greatly im- 
paired in their function, and the cicatricial parts were the scat of uneasy sensa- 
tion of itching, and this sometimes prevented sound sleep. Disabled for service, he 
was on March 16th, 1895, invalided for life and granted a pension according to the 
regulation. (Of the two illustrations produced here, one is of the burns at the tini i of 
admission, and the other is a stereotype of the cicatricial keloid from the phot 'graph 
taken after recovery). 

335. Burns of the face and limbs : — S. Hayashi, aged 23, a member of 

the magazine parly of the Matsushima, in the battle of the Yellow sea, was engaged 
in lifting shells from the magazine in the fore part of the lower deck, when a 80.5 c. 




T Kvurokmva. .Able seaman Matsushima' I. J. S. 

Cheloid scar of burns. 



BURXS. 211 

m. shell burst against the shield of No. 4 port siile-gim on the lower deck. At the 
moment abundant ammunition stored for the side-gnus were set on fire, and by the 
flame of the explosion he received burns of the 2nd degree on the face, the right upper 
and lower limbs, and the inner side of the left leg. The parts were dressed with oiled 
lints and on the 20th, he was conveyed to the Sasebo Naval Hospital. At that time, 
blebs were formed on the burned parts, in some places, while the epidermis was east off 
others, exposing the true skin. The burns were washed with boracic lotion and 
wet boracic lints applied. On October 11th, he completely recovered and returned 
to service. 

Shortly after his return to service, eczema appeared on the burned parts, and 
gradually spread, accordingly on February 19th, 1895, he was again admitted to 
the Sasebo Naval Hospital. Then, the eye-lids, corners of the mouth, neck, and both 
legs had eczema, the eye-lids were excoriated and the conjunctiva? congested. The skin 
of the rest of the body was dry desquamating scales. Above conditions oscillated 
between improvement and retrogression to the failure of all measures of treat- 
ment. This was to be attributed to the impaired nutrition of the skin consequent to 
the burns, and thus judged no longer able for service, he was on January 31st, 1896, 
dismissed, and granted a pension for life according to the regulations. 

330. — Burns of the face, chest, abdomen and upper iimbs : — 3. Mitarashi, 
aged 21, a member of the magazine party of the Matsnshima, in the battle of the Yel- 
low sea, was lifting shells at the entrance of the fore magazine, when a 30.5 c. m. shell 
burst striking the shield of No. 1 port side-gun in the fore part of the lower deck, at 
the same time causing the ammunition stored for the side-guns to explode. By 
the flame of explosion, burns of the 1st degree were inflicted on the face, chest, 
abdomen, and of the 2nd degree, on the inner side of the right upper and the outer 
side of the left upper limb. The burns were dressed with oiled lint, and on the 20th, 
the patient was conveyed to the Sasebo Naval Hospital. On admission, the burns of 
the face, chest and abdomen presented a dark reddish colour ; those of the upper limbs 
had vesicles on or the epidermis stripped off. The burns of the 1st degree were 
painted with a mixture of boracic acid and olive oil, and those of the 2nd degree 
dressed with wet boracic lint. On October 1st, he completely recovered, and 
returned to service. 

337. — Burns of the head, face, neck and limbs : — J. Matsuo, aged 22, a 

seaman of the Matsnshima, in the battle of the Yellow sea, was carrying shells to the 
upper deck, when a hostile shell burst on the lower deck, and at the same time setting 



212 BURXS. 

on fire the ammunition stored for the side-gun. By the flame of explosion, 
burns of the 2nd degree were inflicted on the head, face, neck, right shoulder, 
forearms and the lower part of legs. The burns were dressed on board the ship, 
and on the 20th, he was admitted to the Sasebo Naval Hospital. On admission, the 
burned parts were covered with blisters, and the epidermis stripped off at places, 
exposing the true skin. The face was covered with scabs, the conjunctivae being 
slightly congested and attended by photophobia. On October 1st, the burns of 
the shoulder healed, and the rest were nearly covered with new epidermis, 
while that extending from the elbow joints to the forearms, still presented granul- 
ating surfaces with pus discharge. On the 11th, the burns of the face and legs were 
healed. On January 2nd, 1895, the burns of the forearms were healed by cicatrices. 
However, the epidermis being very thin it was liable to break, and the movements of 
the elbow joints were imperfect. Local warm bathing, massage, and liniments were 
resorted to. On April 0th, the patient almost recovered and returned to service. 

338.— Barns of the head, face, neck, upper limbs and feet : — H. Matsuo, 
aged 30, senior blacksmith of the Matsusbima, in the battle of the Yellow sea, was 
passing by the side of No. 1 starboard side-gun, in the fore part of the lower deck, 
when a 30.5 c. m. shell burst striking the shield of No. 4 side-gun, and at the same 
time setting on fire the ammunitions for the side-guns. By the flame of the explosion, 
he sustained burns of the 2nd degree on the head, face, neck, right upper arm, left 
forearm, and the ankle joints to the dorsi of feet. The burns being simply dressed on 
board at the time, he was, on the 20th, conveyed to the Sasebo Naval Hospital. On 
admission, the hair of the scalp was singed, and the integument covered here and there 
with scabs ; the face blackened by the powder flame, and the ear-lobes stripped of the 
epidermis. As to the burns of the neck, and upper and lower extremities, there were 
vesicles, or the epidermis had excoriated, oozing serum. They were washed with solu- 
tion of boracic acid, and wrapped with wet cloths saturated with the same lotion. On 
the 26th, the epidermis of the face was renewed, and the discharge from the burns of 
the upper and lower limbs lessened and new epidermis began to grow from the 
margins. On October 5th, the burns of the face and upper and lower limbs were 
nearly healed, so the only remaining parts were the ulcerated parts of the ear-lobes, 
and granulating part of the neck. Boracic ointment was applied. On the 20th, the 
burns were healed without leaving cicatrices, and on the 22nd, he completely 
i-emwred and returned to service. 



BURXS. 213 

339— Burns of the face, neck, and limbs : — 0. Kawagachi, aged 31, a car- 
penter of the Matsusbima, in the battle of the Yellow sea, was passing the fore part 
of the lower deck, when a shell burst against the shield of No. 4 port side-gun on the 
same deck and caused the ammunitions stored for the side-guns to explode. At this 
moment, by the flame of the explosion, he sustained burns of the second degree on the 
face, neck, the lower parts of b >ih tore inns to the hands, and the lower part of the left 
leg. The burns were temporarily dressed on board the ship and on the 20th, he was 
admitted to the Sasebo Naval Hospital. On admission, the burns produc d vesicles 
or stripped off the epidermis where serum was oozing. The face was covered by black 
scabs with suppurating spots here and there. Wet boracic lints were applied. On 
October 13th, the burns were all healed without leaving cicatrices, and he returned 
to service on the 16th. 

340. — Burns of the face, forearms and left leg : — Y. Kaburaki, aged 23, a 
carpenter of the Matsusbima, in the battle of the Yellow sea, was posted as a fire- 
brigademan near the middle torpedo room, when a hostile shell burst striking the 
shield of No. 4 port side-gun, in the fore part of the lower deck, at the same time 
igniting the ammunition stored for the side-guns. By the Same of the explosion, he 
sustained burns of the 1st degree on the face, and those of the 2nd on forearms, and 
the front and outer side of the left leg. After being dressed on board the ship, 
he was, on the 20th, admitted to the Sasebo Naval Hospital. At this time, the skin 
of the face was congested but there were no vesicles formed ; and the burns of the 
limbs had blebs formed here and there with abrasion of the epidermis. Wet boracic 
lints were applied. On October 14th, the burns completely healed and he returned 
to service. 

341. — Burns of face, neck, shoulders and forearms : — K. Kawazoye, aged 
21, a blacksmith of the Matsusbima, in the battle of the Yellow sea, was standing, as 
a fire-brigademan, on the fore upper deck, when a hostile shell burst against the 
shield of No. 4 port side-gun, in the fore part of the lower deck. At the same time 
fire started by the explosion of ammunition stored for side-guns, and by its flame he 
sustained burns of the 2nd degree on the face, neck, shoulders, forearms and bauds. 
Urgent relief having been afforded on board the ship, the injured man was, on 
the 20th, admitted to the Sasebo Naval Hospital. On admission, the face was covered 
with black scabs ; the conjunctiva was congested and the eye sight impaired. The 



•214 BUKXS. 

burned parts of the neck and forearms were skipped off exposing the true skin. 
The burns were dressed with wet boracic lints, and the eyes with cold compress. On 
October 14th, the burns were all healed. Congestion of the left conjunctiva still 
lingered, and the sight was not restored yet, but the refractive bodies and fundus 
were found to be sound. Boracic compresses and astringent collyrium were used. 
On November 5th, he completely recovered and returned to service. 

342.— Burns of the head, face, neck and limbs : — K. Masuda, aged 25, a 
seaman of the Matsushima, in the battle of the Yellow sea, was distributing grease to 
the guns in the fore part of the lower deck, when a shell burst against the shield of 
No. 4 port side-gun on the same deck; at the same time igniting the ammunitions of 
the side-guns. By the flame of explosion he received burns of the 2nd or 3rd degree 
on the head, face, neck, forearms, hands, right thigh and both legs. The burns were 
temporarily dressed on board the ship, and he was, on the 20th, admitted to the Sa- 
sebo Naval Hospital. On admission, the hair of the scalp was singed, the integument 
having here and there blisters ; the face covered with thick black crusts ; prominent 
parts such as the ear-lobes, nose, and coin exposed the true skin, the epidermis being 
denuded; the limbs also presented blisters or excoriations, the burns on the outer side of 
the right thigh and back of right hand were of the 3rd degree, the subcutaneous areolar 
tissues and fascia were deeply eroded presenting a sloughy appearance, the general 
strength failing, the patient suffering great distress. Boracic wet compresses were 
applied, and special attention paid to tonic measures. By" October 4th, the burns of 
the face, k it hand and foot began to grow epidermis, and the deeply i idled parts of the 
right hand and thigh were showing granulation. The ear-lobes were remarkably 
swollen, the cartilages mortified accompanied with subcutaneous accumulation of pus, 
which was given vent by an incision. On November 11th, the other burrs except those 
on tie' ears, right hand and thigh, had healed over without leaving any cicatrix. By 
January 10th, of the next year, all the burns were healed, and the debility decidedly 
improved But on the back of right hand an extensive cicatrix resulted, and the extens- 
or tendons of each finger became adherent; all the fingers became stiffened and could 
not be moved ; also the wrist joint shared in the impairment of its movements. The 
ear-lobes, in consequence of dissolution of the cartilages had become withered thus 
destroying th< LI' contour, and the auditory canals were, by a large part, closed, so that 
the hearing was interfered with. This disabled him for service and be was, on March 
17th, dismissed, and granted a pension according to the regulation. 



BURNS. 215 

343 .— Burns of the face and forearms ; — I. Fnjita, aged 2G, a seaman of 
the Matsusliima, in the battle of the Yellow sea, was acting as an assistant signal-man 
on the fore part of the conning tower, when a hostile shell burst on the fore part 
of the lower deck, at the same time firing the ammunition stored for the side-guns. 
By the flame of explosion coming out to the upper deck, he sustained burns of the 
2nd degree on the face, outer sides of the forearms, and the backs of both hands. 
The injured man receiving temporary treatment on board the ship was admitted to 
the Sasebo Naval Hospital on the 20th. On admission, the face was blackened by 
powder flame, the hair of head singed, and the forearms and backs of the hands were 
studded with blisters and excoriations. The burns were dressed with wet boracic 
gauze. On October 2nd, the burns of the face were healed, and on the 9th those of 
the upper limbs. On the 11th, he returned to service. 

344.— Burns of the face and forearms with sprain of the right 

ankle : — A. Fukumori, aged 33, a member of the fore torpedo of the Matsusliima, 
in the battle of the Yellow sea, was at work in the fore torpedo room, when a shell 
burst on the fore part of the lower deck and set on fire the ammunition stored for 
the side-guns. By the resulting flame rushing into the room, he received burns of 
the 2nd degree on the face, ears, and firearms, and at the same time, being thrown 
down by the shock of the explosion, the right ankle joint was sprained. The injured 
man was temporarily treated on board the ship, and on the 20th conveyed to the 
Sasebo Naval Hospital. When admitted, the burned parts were blistering and the 
epidermis coming off in places, attended by the formation of pus. The right ankle 
joint was swollen and of a purplish colour, the pain preventing him from walking. 
The burns were dressed with wet boracic gauze, and the ankle joint with lead lotion. 
By the beginning of October, the burns of the face were completely healed : and 
those of the forearms contracted to half the original sizes, the swelling of the ankle 
was gradually subsiding. On the 25th, the burns were all healed. The patient 
happened to be affected with sore throat, this was treated by gargle of chlorate 
of potash. On November 1st, the swelling of the ankle joint had entirely disappear- 
ed, but the local skin heat was comparatively high and a slight pain was felt in 
walking. Tincture of iodine was painted on. On the 14th, the patient returned to 
service. 

345.— Burns of the face and upper extremities : — H. Nakarnura, aged 34, 
a cook on board the Matsusliima, in the battle of the Yellow sea, was going up the 



210 BURNS. 

1st hatch in the fore part of the lower deck, when a shell burst against the shield 
of No. 4 port side-gun in the fore part of the lower deck, at the same time exploding 
the ammunition stored for the side-guns. By the flame of the explosion, he received 
burns of the 1st degree on the face, and that of the 2nd degree on the right upper 
arm and left forearm to the end of the fingers. After temporary treatment on hoard 
the ship, lie was, on the 20th, conveyed to the Sasebo Naval Hospital. On admis- 
sion, the face was blackened, the ear-lobes, arm and forearms stripped of epidermis 
with blisters here and there. Wet boracic gauze was applied. He returned to 
service on October 14th completely healed. 

346.— Burns of the faca, neck, chest and limbs with rupture of tympa- 
nic membranes : — G. Tanata, aged 29, a seaman of the Hiyei, in the battle of the 
Yellow sea, was carrying a wounded man on the upper deck, to the surgery in the 
ward-room in the rear of the lower deck, when a 30.5 cm. hostile shell exploded in the 
room. By the flame of the explosion, he sustained burns of the face, left side of the 
neck, the chest, the back, and the upper and lower extremities. On the same occasion 
all the medical stall' on board were killed, so being temporarily treated by his com- 
rades, he was properly treated by a surgeon from another ship, when the vessel 
arrived the next morning at the rendezvous near Cape Choppeki, and on that day, 
transferred to the transport Genkai-marn, and on the 21st admitted to the Sasebo 
Naval Hospital. On admission, the face was burned black with deep excoriations on 
it. The left side of the neck and chest had blisters, and nearly the whole of the left 
arm, right forearm, and left leg sustained burns of 2nd degree. The membrana 
tympani of both ears were ruptured. The burns were dressed with wet boracic 
gauze, and the ears plugged with antiseptic cotton wool. On the 30th, the burns of 
the face and neck were healed the parts being spotted with brownish dots ; the fore- 
arms began to heal, while the rest was still ulcerating and discharging pus. This day 
the patient was transferred to the Knre Naval Hospital. Some time after, there ac- 
curred pus discharge from the ears attended by pain, so the interiors were examined 
and both tympanic membranes which had been lacerated were recoguized still to 
remain widely open, the right ear having almost lost the power of hearing. They were 
washed with a boracic solution and a mixture of boracic acid and olive oil was dropped 
into them. By October 12th, all the burns had been healed, but the discbarge from 
tlie ears still continued, always accompanied with heaviness of the head. By January 
1 1th of the following year, the discharge from the ears had greatly decreased ; however, 



BURNS 217 

there existed three perforations on the posterior part of the right membrane, and 
one on the anterior part of the left. The membranes were thickened and opaque, 
on examination by watch, the hearing proved to have been reduced to -^5- (right) 
and -j^jj- (left). Antiseptic lotion and administration of iodide of potash were re- 
sorted to. Later on, the discharge of the ears entirely ceased, but the perforations of 
the membranes remained unhealed, the dulness of hearing and somewhat idiotic state 
of the mind were left. Thus disabled for service, he was on April ISth discharged 
from service and granted a pension according to the regulation. 

347— Burns of the face, neck and hands :— D. Matsudaira, aged 36, a 
petty officer of the Yoshino, in the battle of the Yellow sea, was working at the rear 
of the upper deck, when a hostile shell pierced the starboard netting, and exploded 
against the two 12 cm. shells placed along the netting ; as a result, he received burns 
of the second degree over the whole face (especially the right half, lips and ear-lobes') 
the front of the neck, the anterior aspect of the left wrist and palm, and the right wrist 
to the back of the hand and fingers." The hair of the scalp was signed, tin 1 skin 
congested and swollen, or blistered. Dressings of oiled lint were applied, and he 
was on the 23rd, taken on board a transport and on the 20th admitted to the Sasebo 
Naval Hospital. At the time of admission, most of the burns exposed congested 
true skin discharging pus. The burns were gradually healing, when on the 30th, he 
was transferred to the Kure Naval Hospital. At the time, most of the burns were 
covered with new epidermis, though some parts were ulcerated, yet the discharge was 
very slight. On November 5th, the burns were healed without leaving cicatrix, and 
he returned to service. 

348.— Burns of the face, upper arms and shoulder: — S. Niibara, aged 
22, a member of the magazine party of the Matsushima, in the engagement of the 
Yellow sea, was lifting ammunition at the fore magazine, when a hostile shell 
burst against the shield of No. 4 port side-gun in the fore part of the lower deck, 
at the same instant, setting on tire all the ammunition stored for the side-guns. 
By the flame of explosion he sustained burns of the 1st degree on the face, and 
those of the 2nd degree on the shoulders and upper arms. The burns were simply 
dressed on board the ship and he was admitted to the Sasebo Naval Hospital on the 
20th. On admission, the face was blackened by powder, the hair singed. The parts 
extending from the shoulders to the anterior and external parts of the right and left 
arms, sustained burns of the 2nd degree, the epidermis being charred with blisters 



218 BURNS. 

here and there, or were excoriated, exposing the true skin. Wet boracic gauze was 
applied. On the 27th, the epidermis began to form on the face and the sloughed 
cuticles of the upper limbs having separated, fresh ones grew from the margins, so 
that the ulcerated parts were gradually drying. On October 11th, completely re- 
covered, he was sent back to service. 

349.— Burns of the right shoulder, arm and buttock ;— I. Terashi, aged 
23, a member of the magazine party of the Matsushima, in the battle of the 
Yellow sea, was engaged in hauling rip shells from the fore magazine, when a hostile 
shell burst against the shield of No. 4 port side-gun, in the fore part of the lower 
deck, at the same time setting the powder of the side-guns on fire, the exo 
plosion inflicting burns of the 2nd degree on the right side of the shoulder t- 
the outer side of the right arm and on the right gluteal region. The burns were 
dressed with oiled lint, and he was, on the 20th, conveyed to the Sasebo Naval 
Hospital. At that time, the burns had blisters and casting off the epidermis, exposed 
the true skin which was suppurating here and there. Lotion of boracic acid was 
applied. On October 10th, new epidermis completely formed on the burned surfaces, 
which were healed without leaving cicatrix. On the 11th, he returned to service. 

350. — Burns of the left shoulder, hands and left flank :— Y. [sonaga, 
aged 21, a member of the magazine party of the Matsushima, in the battle of the 
Yelhv sea, was on the steps of the fore magazine, when a 30.5 hostile shell burst 
against the shield of No. 4 port side-gun, in the fore part of the lower deck and at 
the same instant ignited the ammunition stored for the side-guns. By the explosion, 
he sustained burns of a slight degree on the right shoulder, ulnar half of both palms, 
the palmar aspect of the fingers and the right lumbar region. By application of 
oiled lint the burns completely healed on the 22ud. 

351.— Burns of the right side of neck and forearms ;— K. Yuwamoto, 
aged 29, a gunner of the Naniwa, in the battle of the Phung-do, July 25th, 1894, 
was firing by the fort of No. 2 15 cm. gun, when the gas escaped out of the gun 
barrel and inflicted burns of the 2nd degri e on the right side of the neck, and the 
for irms. ( Hied lint was applied, an 1 the barns healed on August 6th. 

(C) BUENS OF LOCAL PART. 

352. Barns of the faoe : — H. Tanaka, aged 28, one of the gun-crew of the 
Naniwa. iu the battle of Phung-do, was firing from the fort of Mo. ti side-gun, when 



BTJBXS. 219 

the gas escaped from the next gun, indicting on him burns of the 2nd degree on the 
left half of the face, and the ear of the same side ; also a slight burn on the left 
conjunctiva. To the burns oiled lint was applied, and boracic lotion to the eye. 
In course of time, the congestion of the conjunctiva gradually subsided, and the 
bums were completely healed on August 6th by a new growth of epidermis. 

353.— Burns of the right forearm and back of the hand :— K. Yamanaka, 

aged 26, a bandsman of the Matsushima, in the battle of the Yellow sea, was, n~ a 
carrier of the wounded, standing in the fore part of the upper deck, when a 30. 5 c. 
in. hostile shell burst in the forepart of the lower deck. Instantly the shell set 
on fire the abundant powder of the side-guns, the flame of explosion coming up to 
the upper deck, he received burns of the 2nd degree on the right forearm and back 
of the hand. It was dressed with oiled lint and healed on October 3rd. 

354. — Burns of the left forearm: — K. Kimura, aged 31, a seaman of the 
Hiyei, in the battle of the Yellow sea, was steering the rudder-wheel on the quarter- 
deck, when an enormous hostile shell exploded in the ward-room at the rear of 
the lower deck, by the shock he was thrown down through the sky-light of the 
ward-roon, where fire had burst out just before, so he received a burn on the left 
forearm. On examination, the burned part had blistered to a large size and the 
surrounding skin was congested. The blisters were opened to give vent to the serum, 
and the part was dressed with wet boracic gauze. On the 25th, sloughed epidermis 
came off and the true skin exposed. Boracic ointment w T as applied and the burns 
were gradually covered with new epidermis, and completely healed on October 2nd. 

355. — Burns of the palm of the right hand and contusion of the left 
buttock : — I. Hamada, aged 24, a member of the magazine party of the Matsushima, 
in the battle of the Yellow sea, was conveying shells in the fore part of the lower 
deck, when a hostile shell burst on the same deck. At the moment, the powder 
provided for the side-guns exploded, by the flame of the powder he received burns of 
the 1st degree on th^ palm of the right hand, contusion of the left gluteal region 
by a wooden splinter. To the burns oiled lint was applied, and spirits of camphor to 
the contusion. On the 24th, he had completely recovered. 

350.— Burns of the back and abrasion of the scalp :— C. Mnrata, aged 
24, a member of the magazine party of the Matsushima, in the battle of the Yellow 
sea, was hauling up shells from the magazine in the fore part, when a hostile shell 
burst in the fore part of tha lower deck. At the same time, the ammunition provided 



220 SC'ALD. 

for the side-guns exploded, by the flame of explosion lie sustained burns on the 
back, and an abrasion on the left parietal region by a flying shell fragment. Being 
temporarily treated on board, the injured man was admitted to the Sasebo Naval 
Hospital on the 20th. At the time of admission, the burns on the back had blisters 
here and there, and the epidermis stripped off exposing sore surfaces from whence 
serum was oozing. The shell-wound on the left parietal region was of a round shape 
and superficial and a healthy granulation had developed. The burns were dressed 
with wet boracic gauze, and the scalp wound with sublimate gauze. Progress was 
favorable, and the patient completely recovered on October 5th. 

357. — Burns of the thighs : — G. Senokuchi, aged 22, a member of the maga- 
zin party of the Matsushima, in the battle of the Yellow sea, was hauling up shells in 
the fore magazine, when a hostile shell burst in the fore part of the lower deck ; at the 
sain.- time igniting the ammunitions provided for the side-guns, ho sustained by the 
explosion flame, burns of the 1st or 2nd degree on the inner sides of both thighs. 
They were dressed with oiled lint and completely healed on October 3rd. 

2">S. — Burns of the right leg : — T. Onodera, aged 29, one of the gun-crew of 
Yoshino, in the battle of the Yellow sea, was standing by No. 8 gun on the port 
side of the quarter deck, when a hostile shell entered piercing through the starboard 
netting, and exploded against the 12 c. m. shells placed along the netting. By the 
flame of the explosion, he received burns of the 2nd degree on the lower third of the 
right leg to the dorsum of the foot. The burns were dressed with oiled lint and he 
was admitted, on the 26th, to the Sasebo Naval Hospital. At the time, the burns 
were exposing the congested true skin ; the epidermis having been stripped off and 
oozing serous effusion. Dressed with wet boracic gauze, he was, on the 30th, 
transferred to the Kure Naval Hospital. He made favorable progress, the burns 
completely healed and he returned to service on the 23rd of October. 

10.-SCALD 

359.— Scald of the whole body: — K- Nakatsnma, aged 41, non-commissioned 
engineer of the No. 9 torpedo boat. 

860. H. Goto, aged 28, a senior stoker of the same boat as above. 
361. — M. Mayeyama, aged 24, a stoker of the same boat. 
3G2. -('. Tsunamoto, aged 24, a stoker of the same boat. 



SCALD. 221 

3G3. — T. Ito, aged 24, a stoker of the same boat. 

The foregoiug cases occurred on the same torpedo-boat on February 4th, 1895, 
when she ventured into the port of Wei-hai-wei talcing the advantage of the dead 
of night to make an attack on hostile vessels. They were working in the engine- 
room, under a shower of the enemy's shells, the boat received 13 of them, of which 
one that struck the boat at 4. 30 at dawn next morning, entered by the port side and 
piercing the upper part of the boiler made a large hole of 9 inches in diameter. Steam 
and boiling water gushed out from this hole scalding all of them to instant death. 

364. — I. Ajisono, aged 23, a stoker of the same boat us above. He was scalded 
together with others in the boiler room by gushing steam and boiling water through 
the rent in the boiler. He was rescued by No. 19. torpedo boat, from which he was 
at 6. 35 a. m. transferred to the mother-ship Omi-maru. Examined by the surgeon 
of the ship, he was found scalded all over the body ; the face, neck, chest, forearms 
and legs sustained scalds of the 2nd degree, the epidermis being softened and ex- 
foliating here and there, or blistered at places. The back, abdomen, upper arms, 
thighs presented a reddish hue having wrinkles owing to the softening of epidermis. 
He complained of intense thirst and chilliness with alarming signs of collapse. 
Brandy was given and wet boracic acid packing applied. About 11 a. m. his suffer- 
ing increased, he was rolling about in bed, and opium was given, at 7 p. m., dyspnoea 
set in, heart action failed, pulse became thready and occasional delirium supervened. 
At 3.30 a. m. on the Gtii, the symptoms became worse, respiration stertorous, pulse 
indistinguishable, the mind stupified and responses unintelligible. Stimulating 
measures were resorted to in vain, and the patient expired at 4 o'clock in tin- 
morning. 

365.— Scalds of the face, hands and legs :— G. Takalmshi, aged 28, senior 
stoker of the same boat as above. He sustained scalds of 2nd degree with the same 
fate as above, on the face, ear-lobes, hands and legs. Rescued by No. 19 torpedo-boat 
that accompanied her, he was placed at 6.35 a.m. on board the mother ship Omi-maru. 
Examined by the surgeon of the ship, epidermis of the scalded parts was softened 
and stripped off at places. The parts were painted with olive oil and dressed with 
sublimate gauze. On the 6th, dressings were renewed, and blisters opened. The 
patient was transferred to the hospital ship Kobe-maru, and on the 7th, the epidermis 
of the affected parts became grayish black and contained serum or pus beneath it. 
Accordingly the sloughed epidermis was snipped off and the parts washed with 



■222 FEOST-BITE. 

boracic lotion and dressed with wet boracic gauze. The temperature rose to 37 : .6 C. 
On the Stb, the face became (edematous, and the forehead slightly suppural 
temperature indicated 3S : C. Dressing was changed. On the 13th, the affected parts 
having almost entirely cast off the epidermis exposed the true skin which 
discharged copiously, hut the temperature oscillated between 37". 5 C. aud 37 D .G C. 
On the 20th. the patient was admitted to the Sasebo Naval Hospital. At the tim 
his admission, the scalded parts were denuded of epidermis actually forming ulcers 
with discharge. The former treatment was continued. On the 27th, pus disci. 
began to diminish greatly, and new epidermis developed from the margins of the scald. 
Boracic ointment was substituted. By March 8th, the epidermis completely formed 
over the scalded surfaces, hut the cicatrix presented here and there a keloid appear- 
ance. In the middle of April, patches of a red-brown colour appeared on the face ; 
and a small cicatrix on the inner eanthus of each eye, and keloid cicatrices were 
formed on the hack of hinds and fingers, inner and outer sides of the right 1 g, - 
that an ugly appearance was left in these parts. However, the limbs and other parts 
being sound in their function, lie returned to service on May 0th. 

36C. — Scald of the right leg: — E. Eiju, aged 80, a stoker of the same boat as 
above sustained scald of 1st degree in the lower third of the right leg. He was res- 
cued by No. 19 torpedo boat and transferred on board the mother ship Omi-maru. 
He was dressed by the surgeon of the mother ship with olive oil and sublimate gauze. 
The scalded parts dried without suppuration and completely healed on the 11th of 
the same mouth. 



11. -FROSTBITE. 

367.— Death by extreme cold:— K. Okimoto, aged 32, a seaman of the N 
22 torped i February 4th, 189-">, availing herself of the depth of night, the 

boat attempted to enter the port of Wei-hai-wei and made an attack on the hostile 
vessels. On her way back, at o a. m. she ran aground just below the fort of Liubyoshi 
so firmly that floating her off was hopeless. The crew therefore got on a lif 
and were making for the land when the boal I. Falling into the sea, he swam 

ire and reached the occupied fort of Lokkakushi, hut the time being the col 
season, he was frozen to death before medical relief could he afforded. 



FROST-BITE. -223 

368. — Frost-bite ani Contusion : — U. Teshirua, aged 27, crew of No. 22 
torpedo boat, met with the same fate as the above man. Falling into the sea, he swam 
ashore as best he could, from whence despite the difficulty of walking on account 
of his frozen limbs he contrived by creeping along to get to our occupied fort of 
Lokkaknshi. On the way, he often fell from prostration receiving severe bruises, but 
mustering all his strength, he arrived at the fort when he was given relief by surgeons 
of the 23rd regiment of tlie infantry, and on the same day was admitted to the 2nd 
Permanent Army Hospital at Kosan-go. The back, loins, gluteal regions and legs 
had pains ; the lower limbs lost power which disabled him from standing ; the fingers 
of both hands lost their movement-;, and were slightly swollen and tender on pressure; 
the toes were somewhat swollen from determination of blood. Spirit of camphor was 
rubbed on the affected parts, and the patient was kept warm and at rest. On the 
9th, symptoms improving a little, he was removed on board a transport and on the 
18th admitted to the Army Hospital at Hiroshima. At the time of his admission, 
he was found still impaired in nutrition, temperature 35". 6 C, pulse 60, appetite 
impaired, bowels constipated, pain at several parts of the head, which he said to be 
severest in the forehead and the right temple. As to the chest, dull pain was felt 
along the outer margin of the right pectoralis major and in the left 2nd intercostal 
space, which was increased by deep inspiration. On the back, the pain was felt on 
percussion in the left inter-scapular region, and over the 6th, 7th and 8th dorsal 
vertebra 3 , and all over the sacrum. Also pain was felt in the shoulder and the elbow 
joints ; the fingers of both hands except the thumbs had anaesthesia and paresis with 
lingering determination of blood and swelling ; the legs had pains in the calves ; both 
feet had pains also and the toes were numbed ; the patellar reflex was strikingly in- 
creased, and walking was very difficult. Under suitable treatment in the hospital, 
he recovered greatly and was i 'ii March 10th transferred to the Kure Xaval Hospital. 
At that time, nutrition was greatly restored ; temperature and pulse returned to 
normal condition ; the fingers and toes were cold and slightly congested, and the 
skin of the palmar surface of the index, middle, and ring fingers, was stretched 
tightly and excessively sensitive, even mere touch gave severe pain. The pain in 
both calves, and dull pain in the right side of chest was still lingering slightly. 
Warm bath, friction of the skin with stimulating liniment and tonic and nutritious 
diets were chiefly resorted to, and on April 2nd, completely recovered, he returned to 
service. 



0-24 DROWNING. 

12.-DR0WNING. 

3G9. — Death by drowning ; — T. Suzuki, aged 28, Sub-lieutenant on No. 22 
torpedo-boat, on February 4th, 1895, the boat availing herself of the dead of night, 
ventured into the port of Wei-hai-wei and made an attack upon the enemy's vessels. 
On the way back, the boat got aground at the foot of Liubyoshi. Finding it hope- 
less to rescue the boat, he jumped into the water and attempted to reach the shore, 
but it being just the coldest season of the year, he lost the use of his limbs, and 
was drowned. 

370. — U. Furuichi, aged 27, a seaman of the No. 22 torpedo-boat met with 
the same fate with his superior officer above mentioned. 

371. — E. Ono, aged 23, a stoker of No. 22 torpedo boat was drowned by the 
same cause as above. 



CHAPTER III. 

STATISTICS OF INJURIES. 

The total number of the killed and wounded in the late war 
between Japan and China was 371, of which 6 eases occurred in the 
battle of Phung-do, 298 at the Yellow sea, 66 at Wei-hai-wei and 

1 at the Pescadores. The six cases in the battle of Phung-do were 
not attributable to hostile shells, but to the shock of their own guns at 
the time of firing, or to the gas produced by the explosion of the gun- 
powder, and one man at the fight of the Pescadores was wounded by 
an enemy's bullet while serving as a landing party ashore, so in these 
two engagements none on board our war-ships sustained any injury. 
We do not therefore see any necessity to record these seven cases in 
a separate statistic. The statistics recorded in the present chapter 
will only refer to the killed and wounded in the battles of the Yellow 
sea and Wei-hai-wei. 

1.-0N THE BATTLE OF THE YELLOW SEA. 

The number of hostile shells received by our several war-vessels 
during the engagement of the Yellow sea is as follows : — 13 by the 
Matsushima, 8 each by the Itsukushima, Fuso, and Yoshino, 11 by 
the Hashidate, 3 by the Chiyoda, 23 by the Hivei, !) by the Xaniwa, 
5 by the Takachiho, 4 by the Akitsushima, 30 by the Akagi, and 
12 by the Saikyo-maru. The number of the killed and injured by 
these shells were as follows: — 113 in the Matsushima, 26 in the 
Itsukushima, 12 in the Hashidate, 14 in the Fuso, 55 in the Hiyei, 
10 in the Yoshino, 2 in the Takachiho, 14 in the Akitsushima, 28 in 



±26 



OX THE BATTLE OF THE YELLOW SEA. 



the Akagi, 11 in the Saikyo-maru, Besides these, there were some 
wounded otherwise than by shells : that is, 5 in the Itsukushima, 1 
each in the Hashidate, Hiyei, Takachiho, and Akitsushima, and 2 each 
in the Yoshino and Naniwa. 



The statistics concerning them are the 



following:. 

O 



TABLE NO. I.— NUMBER OF KILLED AND WOUNDED ARRANGED 
ACCORDING TO VESSELS. 



Vessels 


1 '.IMPLE- 
MENTS 


KlLLEU 


Wounded 


Total of 
killed or 

WOONDED 


Percentage 
of k.or w. per 
complements 


Matsushima 


4'25 


35 


78 


113 


26.59 


Itsukushima 


362 


13 


18 


31 


8.56 


Hashidate 


362 


3 


10 


13 


3.59 


Fuso 


353 


2 


12 


14 


3.97 


Cliiyoda 


313 










Hiyei 


308 


19 


37 


56 


18.18 


Yoshino 


119 


1 


11 


12 


2.86 


Naniwa 


358 




2 


2 


0.56 


Takacliilio 


359 


1 


2 


3 


84 


Akitsushima 


320 


5 


10 


15 


4.69 


Akagi 


129 


It 


17 


28 


21.71 


Saikyo-maru 


118 




11 


11 


9.32 


Total 


3,820 


90 


■jus 


298 


7.79 



As shown in table Xo. 1. considering from the totals of the 
killed and wounded, the Matsushima stands first, the Hiyei second, 
the [tsukushima third, the Akagi foui'th, the Akitsushima fifth, the 
Fuso sixth, the Hashidate seventh, the Yoshino eighth, the Saikyo- 
maru ninth, the Takachiho tenth, and the Naniwa eleventh ; consider- 
ed however, by the ratio of the killed and wounded to every hundred 
of force, the order musl be considerably altered : that is. the Matsu- 



OS THE BATTLE OF THE YELLOW SEA. 



■221 



shima stiinds first. the Akagi second and the Hiyei third, then come 
in order the Saikyo-maru, Itsukushima, Akitsushima, Fuso, Hashi- 
date. Yoshino, Takachiho, Nnniwa ; amongst them, the Matsushima, 
Akagi and Hiyei arc strikingly high, while the Chiyoda had none of 
her inmates killed or wounded. 

TABLE NO. II.— NUMBER OF KILLED AND INJURED 
CLASSIFIED ACCORDING TO RANKS. (A) 



\. Ranks. 
Vessels, ^v. 


00 

a 

Q 


'A 

a 
z 

5 
z 


■j: 

Z 

: 

-z 
S 
a 
i. 


X 

a 

r- 

■Ji 

< 

< 


i 


Z 

< 
X 


y: 

M 
o 

EC 


; 5 

2 _ 

O z 


r. 

'<£ A 

-- z 

* < 

^. < 


< 


< =-. 

-z '- 


Matsnshima J 

(Inj.... 


2 
6 




1 




2 

7 


33 
63 


3 




5 


38 

71 


35 

78 


Itsukushima ) 

(Inj.... 




1 






1 


9 
12 


3 

4 




1 
1 


13 
17 


13 

18 


HasliiJate ...) 

(Inj.... 


2 
1 








2 

1 


1 

7 




1 


1 


1 
9 


3 
10 


Fuso ) 

(Inj.... 


2 








2 


2 
10 








2 

in 


2 
12 


„. . (Kil.... 
Hivei J 

(Inj--.. 


4 




2 


1 


■I 


13 
25 


1 

3 


1 

2 


1 
3 


1G 

Oij 


19 
37 


v ,. (Kil.... 
(Iui.... 


2 








2 


1 
8 




1 




1 

!) 


1 
11 


„ . 1 Kil.... 
Nannva ...I 


1 








1 




1 






1 


2 


Tukacliilio ...) 

(Iuj.... 












1 
1 






1 


1 


1 
2 


.... . . (Kil.... 

Akitsusmma } 

( [nj. ... 


1 








1 


4 
8 


2 






1 

in 


5 

10 


., . (Kil... 
Akrtgl ll,,i.... 


2 
2 








2 

2 


8 
14 


1 




1 


9 
15 


11 
17 


c .. (Kil.... 
Saikyo-maru •! 

(Inj.... 






1 




1 


7 


3 






in 


11 


General Total} T . 
( I". 1 - 


7 
18 


1 


2 
2 


1 


111 

n i 


72 
155 


4 

17 


1 
4 


3 

11 


80 
L87 


90 
208 



223 



ON" THE BATTLE OF THE YELLOW SKA. 



TABLE NO. HE. — NUMBER OF KILLED AND WOUNDED 
CLASSIFIED ACCORDING TO RANKS. <B> 





Ranks. 


Number. 


Killed. 


Wounded. 


1'OTAIi OF 

KIL. AND 
WOUNDED. 


KATIO OF KIL. 

AND WOUNDED 

FEB 100 OF 

FORCE. 


DO 


Officers 


251 


7 


18 


25 


9.96 


< fc. 

1 C 


Engineers . . . 


93 




1 


1 


1.08 


Surgeons 


2 Li 


o 


2 


4 


13 38 


'— < 


Paymasters ... 


26 


1 




1 


3 85 




tal 




in 


21 


31 






Seamen 


2,375 


72 


155 


227 


9.56 


f gjj 


Stokers 


818 


4 


17 


21 


2 57 


Medical 
Attendants... 


34 


1 


4 


5 


14.71 


S < | 


Paymaster's 














Assistants ... 


203 


3 


11 


14 


6.90 




Total 


3,430 


80 


187 


207 


7.78 


Gkanj 


J TOTAL 


3,826 


90 


208 


298 


7.7'." 



Tables Nos. - and 3 are formed in order to investigate the re- 
lation of death and injury rates to ranks. Table No. 2 is formed on 
eaeh vessel, but table No. .'> on tbe aggregate numbers of respective 
ranks on board all the vessels, under the two great divisions of 
' Officers and Warrant Officers,' and ' Petty Officers. Seamen, and Non- 
combatants,' of which the former is subdivided into Officers, En- 
gineers, Surgeons and Paymasters, and the latter into Seamen. 
Stokers, Medical attendants and Paymaster's assistants, so that 
the ratio of the killed and wounded in the respective rank may he 
compared. Thus we see that under the head of 'Officers and Warrant 

Officers,' the actual number of the killed and wounded is greatesl in 
Officers, followed by Surgeons, Engineers and Paymasters hav- 
ingr only 1 each; under the head of ' Petty Officers, Seamen and Non- 



OX THE BATTLE OF THE YELLOW SEA. 229 

combatants,' Seamen come the first followed successively by 
Stokers and Paymaster's assistants, Medical attendants having the 
least number. These ranks, however, having originally very different 
numbers of their own, the true rates of injuries can not he ascertained 
unless considered in comparison with the number of each rank, so in 
the foot column of table 3 the rate percent of the killed and 
wounded to the whole number of each rank is computed; and from 
this we learn that both under the heads of 'Officers and Warrant 
Officers' and "Petty Officers, Seamen and Nbncombatants,' Surgeons 
and Medical attendants have the largest rate ; next come Officers 
and Seamen, then Paymasters and their assistants, Engineers and 
Stokers having the smallest rate. 

In naval battles, hostile shells do not choose any one place for 

striking a ship above the water-line : those who are standing on the 
bridge, or those who are fighting on an open battery or those who are 
at work on a lower deck, run an equal risk of being struck. So there 
is no reason for supposing that there would be any difference in the 
number of injuries between combatants and noncombatants, as Long 
as they are equally engaged in their duties above the water-line. 
Thus in the battle of the Yellow sea, the surgeons who were mostly 
on the lower deck had a comparatively great number of killed and 
wounded, and the combatant officers and seamen who stand next to 
them in degree of injuries had likewise a large number of wounded on 
the lower deck. On the other hand, below the water-line, one is 
almost always safe, and the only shell that struck below the water line 
was that which reached the Naniwa (this knocked through the ship at 
about L foot below the water line and exploding there the fragment- 
entered the coalbunker without inflicting any injury to person). It 
is therefore natural that the engineers and stokers who are always en- 



230 



OX THE BATTLE OF THE YELLOW SEA. 



gaged below the water line were the least injured. It is true that six 
of the magazine men in the Hivei and rive of the stokers in the 
Itsukushima. who all were working below the water line were at 
once killed or wounded : the former because the fragments of a shell 
that had exploded on a lower deck, fell in the cock-pit at the entrance of 
the magazine, and the latter because a shell which had pierced through 
the middle part of the starboard side, and come through the coal- 
bunker, bit the ladder set against the middle steps of the engine room 
and there exploded. No injury, however, to life was sustained from 
any shell that knocked directly through the ships below the water line. 

TABLE NO. IV.— SHOWING THE RATIO OF THE KILLED AND 
WOUNDED TO THE NUMBER OF SHELLS RECEIVED. 

















_ 


_ 


Y] SSELS. 


Number op the 


HELLS RE 


CK1VKI). 


a 


a 
a 

s 

O 


a a 

* z 

a P 

o o 

. IS 

2 - 


= 1 1 a 
j: y.s. x 

D * S | 

£ - a S 

5 * - ™ 

^ < g 





b ; 
y, r 


Z 

< 


< 



Matsnsliima 


('. 


7 




13 


35 


78 


113 


8.69 


Itsuknshima 


(i 







8 


13 


13 


■2C 


3.25 


Hashidate 


4 


7 




11 


3 


9 


12 


1.09 


Fnso 


4 


4 




8 


2 


12 


14 


1.75 


Cliiyoda 




3 




3 










Hivei 


3 


12 


8 


•23 


1!) 


36 


55 


2.39 


VnslllllO 


2 


1 


5 


8 


1 


9 


1(1 


1.25 


Nauiwa 




3 


6 


9 










Takachiho 


1 


4 




5 


1 


1 


2 


0.40 


Akitsusliima 


1 


3 




4 


~> 


9 


14 


3.50 


Akagi 


4 


18 


8 


30 


11 


17 


28 


0.93 


Saikyo-marn 


3 


9 




12 




11 


11 


0.92 


Total 


34 


73 


•27 


134 


90 


195 


•285 


'2.13 



Besides the lulled and wounded mentioned in this table, there arc the following 
eases due to causes other than hostile shells: — 

5 in the Itsuknshima, 2 each in the Yoshino and Naniwa, 1 each in the Hashi- 
lati Mi-' i - Dalrachiho and Akitsushima, numbering 18 in all. These are however, 
omitted, as they Lave no relation to the ratio of the killed and wounded to the numb- 
er of tlif shells received. 



OX THE BATTLE OF THE YELLOW SEA. 231 

As will be seen from table Xo. 4, if we name the ships in order 
of the ratio of their killed and wounded to the number of shells re- 
ceived, the Matsushima stands foremost, followed successively by the 
Akitsushima. Itsukushima, Hiyei, Fuso, Yoshino, Hashidate, Akagi, 
Saikyo-maru, and Takachiho, while the Naniwa and Chiyoda sustained 
no injury to life from enemy's shells. But if we consider merely the 
number of the shells received, the Akagi has the largest number, the 
Hiyei, Matsushima, Saikyo-maru, Hashidate and Naniwa succeeding; 
then the Itsukushima. Fuso, and Yoshino, these three having the 
same number, after which the Takachiho, Akitsushima, Chiyoda follow 
in order. As however the rate of the killed and wounded bears no 
exact proportion with the number of shells received, we are presented 
with a phenemenon such as is shown by the ' ratio of the killed and 
wounded to each shell received.' This is attributable to the fact that 
the shells received were of various sorts, some being those of heavy 
guns and some of light guns, of which some exploded while others did 
not; and also some that were no more than mere fragments, so that 
the degrees of damages sustained were very different. The ease in 
which the heaviest damages were inflicted and the largest number 
were killed and injured at a time by the explosion of a shell, was that 
of a 30.5 cm. shell that exploded on the lower deck of the Matsushima, 
by which 30 were killed outright and 70 injured at once (about half 
the number by explosion of the ammunition of the ship). A shell 
that exploded in the wardroom of the Hiyei killed 14 and wounded 
26: a 21 cm. ordinary shell that burst ou the upper deck of the Aki- 
tsushima killed 5 and wounded 8; a similar shell that burst in the 
fore torpedo room of the Itsukushima killed 8 and injured;'). And 
in the Itsukushima even the explosion of a 50 m.m. light-gun shot 
killed 4 and hurt (i. On the contrary, a 30.5 cm. shell that fairly 



•232 OX THE BATTLE OF THE YELLOW SEA. 

struck the Saikyo-maru, and a 21 cm. shell that hit the Chiyoda did 
not inflict any striking damages other than piercing the hull, on 
account of their not having exploded. Another remarkable example 
of this kind is seen in the case of a 15 cm. steel shell that fairly struck 
the Voshino in the battle of Phung-do. After piercing through the 
deck-house on the upper deck, it fell into the engine-room and after 
rolling about for a while among the persons in the engine room, it 
came to rest without exploding, inflicting no injury to any one. 
Again the fact that the number of the killed and wounded does not 
hear exact proportion with that of the explosions of shells received, is 
to be accounted for by the fact that damages so done greatly depend 
on the place hit by shells. This will be learned from the two follow- 
ing tables. 



OX THE BATTLE OF THE YELLOW SEA. 



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OX THE BATTLE < >F THE YELLOW SEA. 



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OX THE BATTLE OF THE YELLOW SEA. 235 

From the above table No. 5, we see tlr.it the part that sustained 
the greatest number of shells was ' higher than the upper deek.' which 
received no less than 51 shells, then comes the 'upper deck' which 
received 44, and lastly the ' middle and lower decks' which received 
38. As for the part below the water-line, it received only 1 shell 
and that striking at about 1 foot below the line, was so weakened in 
its force that no remarkable damage was incurred except that some of 
the outer platings were pierced. To compute the proportional rate of 
shells received on the respective decks by percentage, 'higher than the 
upper decks ' is 38.0(3 %, ' the upper decks ' 32.84 %, the ' middle 
and lower decks' 28.36 %, and 'below the water-line' 0.75 %. The rate 
of the killed and wounded does not however bear exact proportion to 
the number of shells received. Thus as is shown in table No. 6, 
134 persons (44.97 %) were either killed or injured on the lower 
decks, 117 (39.2(i %) on the upper decks, 31(10.40 %) above the up- 
per decks, 15 (5.03%) below the water-line and 1 (0.34 %) at the 
place outside of the ship. This result is attributable to the fact thai 
on the lower decks many a person is apt to be injured by broken 
pieces of the walls or of furniture, etc., which inflict damages known 
as indirect-shells, and partly to the fact that in the Matsushima a very 
large number was either killed or wounded by one shell that burst 
on the lower deck and caused the large amount of gunpowder lying 
there to explode. Even on the upper decks more persons were some- 
times injured by indirect shells than by the direct ones, and the upper 
decks might have been the scenes of more numerous deaths and injuries 
than the lower decks, if it had not been that in the late naval battle 
the number of injuries on the upper deck turned out to be compara- 
tively small on account of the explosion of the gun-powder on the 
lower deck of the Matsushima as mentioned above. Above the upper 



•236 



ON THE TABLE OF THE YELLOW SEA. 



deck, it is natural that the injuries sustained were much fewer, for it 
is quite open with only few objects to be struck by shells ; and at the 
same time far fewer persons are stationed there. The few deaths and 
injuries below the water-line were caused, as mentioned already, by 
fragments that Hew down from the shells exploding cm the lower 
decks. — that is, at a place above the water-line. 

TABLE NO. VII— WOUNDS AREANGED ACCORDING TO LOCALITY. 

In tabulating the number of wounds according to locality, those caused by shells, 
shell-fragments and indirect shells will be first given in the next table A. 



Table A. 



Locality of injury. 


Number op killed 
and wounded. 


Perckntagk of killed 
and wounded accord- 
ing to locality. 


The whole body 

The head (inclusive of the fice) 

The neck 

The chest and back 

The abdomen and lumbar region 

The upper limb (inclusive of the scapular reg.) 
The lower limb (inclusive of the buttocks)... 


86 

65 

6 

21 
24 
38 
45 


15.32 
27.66 
2.55 
8.94 
10.21 
16.17 
19.15 


Total 


235 


100.00 



Injuries caused by the shocks of shell-explosions or of firing guns are as shown 

in the next table B. 

Table B. 



LOCALTY OF INJURY. 


Number of kil. 

AND IN.!. 


Percentage of 
injuries according 

to LOCALITY'. 


The head 

The chest and back 

The abdomen and lumbar region 

The upper limbs 

The lower limbs 


9 

1 

2 
7 
4 


39.13 

4.35 

8.70 

30.44 

17.89 


Total 


23 


100.00 



OX THE BATTLE OF THE YELLOW SEA. 



237 



The burns caused by tbe explosion of shells or gun-powder are as shown in the 

next table C. 

Table C. 



Locality of burns. 


Number of kil. 

AND IN.T. 


Percentage of kil. 

and inj. according 

to locality. 


Greater part of the body 

Several parts of the body 

The upper limbs 

The lower limbs 


18 

18 

2 

•2 


45.00 

45.00 
5.00 
5.00 


Total 


10 100.00 



In the foregoing three tables A, B, C, when a man received several wounds, only 
the most severe wound is reckoned, to the exclusion of the rest. Many cases of in- 
juries from shell fragments associated with burns are included in the table A. in order to 
show the locality of injuries. Among the injuries to the ' whole body ' in table A. are 
counted various cases: e.g. cases in which the whole body being mutilated, no particu- 
lar place of injury could be assigned ; cases in which several parts of the body were 
wounded, so as to make it difficult to differentiate any particular locality, and also 
cases in which the whole body was thrown over-board by the explosion of shells. In 
the injuries to the head in table B. are included 8 cases of perforation of membrana 
tyinpani. And in the 'greater part of the body ' in table C. are included those cases 
in which the total area of several burns of the body was so extensive as to cover more 
than one-third of the whole body, and the ' several parts of the body ' includes cases 
in which the burns were so scattered that no particular place could be named. 

The number of injuries caused by projectiles arranged according 

to locality is as shown in table A. from which we see that excepting 
the injury to the whole body, the head has the largest number, then 
in order come the lower limbs, the upper limbs, the abdomen and 
lumbar region, the chest and back ; the neck ranking last. For past 
naval battles of Europe and America, we can obtain no statistics on 
this point. But for land battles, if those injuries where the localities 
were well ascertained are summed up and classified, for the Crimean 



•23S OX THE BATTLE OF THE YELLOW SEA. 

War, the Italian War, the Russo-Danish War, the Austro-Prussian 
War, the Civil War of America, the Franco-Prussian War and the 1st 
Division of our army in the Japan-China War, the results are as 
follows : — Wounded on the head are 50,818, on the trunk 86,618, on 
the' upper limbs 141,418, on the lower limbs 148,547,-427,401 in all. 
To compute the percentage of respective injuries, the head lias 11.89, 
the trunk 20.27, the upper limbs 33.09, the lower limbs 34. 75. Those 
killed outright on the fields of battle are not counted in this number, 
as the localities of the injuries, received by those killed on the spot are 
often doubtful and can not be adduced as reliable evidence. However, 
if we venture a calculation about the killed as far as reports of such 
exist, — that is, about 118 killed in the New Zealand war of England, 
387 in the Russo-Danish war, 1,173 in the American Civil war, and 
119 of the 1st Division of our army in the Japan-China war — the 
percentage will be seen to be 40.24 of the head, 53.97 of the trunk, 
1.79 of the upper limbs, 4.00 of the lower limbs. The proportion 
between the killed and wounded varies with each war. Thus in the 
battles of Alma and Inkerman in 1854 and the attack on Plevna in 
1878, the number of the killed, and that of the wounded on the side 
of the Russians, was nearly equal, while with the French at the same 
battle of the Alma the rate was S.3 of wounded to 1 of killed. Such 
variations will naturally occur according to the character of the battle 
and the nature of the field occupied. However, according to Long- 
more's calculation, based upon 100 battles, the average proportion of 
the killed and wounded is 1 of the former to 4 of the latter. If we 
calculate the foregoing - numbers of the various injuries to the killed 
and of the wounded together, the percentage will be thus : injuries to 
head 17.56, trunk 27.01, upper limbs 26.83, lower limbs 28.60. 
Judging from mere figures, the lower limbs received the largest iium- 



ON" THE BATTLE OF THE YELLOW SEA. 239 

ber of injuries, next the trunk and then the upper limbs, the head 
having the least number. Yet it is natural that the wider the area 
the higher the number of the shells received, and therefore in order to 
make a real comparison of the number of shells received, it is neces- 
sary that the area of the respective regions should be taken into 
account. The rate of the area of the respective regions apt to be struck 
by projectiles, according to Longmore, is 8.51 in the head (inclusive of 
the face and neck), 28.91 in the trunk, 21.14 in the upper limbs, 
41.41 in the lower limbs. Comparing these with the number of shells 
received in each locality, we find the head stands comparatively higher 
than the rest, next the upper limbs, then the trunk and lastly the 
lower limbs. This difference may be accounted for by the fact, that 
in laud fights the head and upper limbs have to be exposed to the 
enemy, while the lower half of the body is often protected by some 
kind of shelter. But on board war-ships there being scarcely any 
such things as parapets, jungles (thickets) or ditches to cover the 
lower part of the body, it would naturally be expected that 
the region that has the widest area should receive the greatest 
number of projectiles. Yet the fact is to the contrary, as is shown 
in the table 7, A. If we arrange the numbers into four groups; 
that is, head, trunk, upper and lower limbs, the injuries of the 
head will show oo.(58 per cent, of the trunk 22.151. of the upper limbs 
19.10, and of the lower limbs 22.61 respectively. Here we see that 
the head though it has the smallest area, shows the highest number 
of injuries, not only comparatively but actually, while the lower 
limbs, most extensive in area have a comparatively small number, so 
that the difference between them is more striking than it was even 
in the land fights. As regards the trunk and the upper limbs, the 
former somewhat exceeds the latter in its actual number of injuries, 



•240 



OX THE BATTLE OF THE YELLOW SEA. 



but making due allowance for their respective areas, the upper limbs 
have sustained a comparatively larger number of injuries. This 
subject will further be dwelt upon under the articles of tallies 
Nos. 1G, and 17. in the section of the attack on Wei-hai-wei in 
connection with the iniuries sustained in that engagement. 

TABLE NO. VIII.— CLASSIFICATION OF INJURIES ARRANGED 
ACCORDING TO THEIR TERMINATION. 



Termination. 
Locality. 




z a 
z p 


5 S 5 

X 


5 
5 


z 


< 


Greater part of the body . . . 
Various parts of the body ... 

Head 

Face 

Neck 

Chest and back 

Abdomen and loins 

Upper limbs 

Lower limbs 


Actual num. 
Percentage. 
Actual num. 
Percentage. 

Actual num. 

Percentage. 
Actual num. 
Percentage. 

Actual num. 
Percentage. 

Actual num. 
Percentage. 

Actual num. 
Percentage. 

Actual num. 
Percentage. 

Actual num. 
Percentage. 


30 
57.69 

23 
53.49 

o 
33.33 

8 
34.78 

18 
09.23 

9 
18.37 


21 

40.38 

3 
6.98 

1 
10.67 

1 
4.35 

3 
11.54 

1 
2.00 

8 
6.12 


15 

75.00 

16 
37.21 

24 

82.76 

3 

50.00 

14 

60.87 

5 

19.23 

39 

78.00 

31 

63.27 


1 

1.92 

5 

25.00 

1 

2.83 

S 

17.24 

10 

20.00 

6 

12.24 


52 
99.99 

20 
100.00 

43 
100.00 

29 
100.00 

6 

100.00 

23 
100.00 

26 
100.00 

50 
100.00 

49 
100.00 


Total 


Actual num. 
Percentage. 


90 33 
30.2(1 11.07 


147 28 
49.83 i 9.40 


298 
100.00 



When the termination of injuries pertaining to various localities 
are classified under four heads of ' Instant death.' ' Subsequent death.' 
'Cured,' and 'Invalided ' as in the table No. 8, we see that deaths 
— both instant and subsequent death — are mosl numerous in the 
column ' greater part of the body.' This can not be otherwise be- 
cause as already mentioned, eases of mutilation of the whole body 
and of extensive burns are included in it. Now, to compute the per- 



OX THE BATTLE OF THE YELLOW SEA. 241 

centage of each column from its actual number of deaths — in the first 
column 'greater part of the body' the instant deaths claim 57.69 
per cent; the ' subsequent deaths ' 40.38 ; excepting only one case of 
burns extending over one-third of the whole body, all the rest belong 
to this column, that is. 51 out of b'2 proved fatal, showing a death 
rate of 98.08 per cent. The mortalities from injuries to other parts 
including both instant ami subsequent deaths come as follows : 
abdomen and loins 80.77 per cent, head (>0.47, neck 50.00, chest 
and back 39.13, lower limbs 24.49. upper limbs 2.00, various 
parts of the body and face no death, and 1 death in the 
column upper limbs was attributable to erysipelas from accidental 
infection. 

Generally speaking, in engagements on land, the instant deaths 
c iwing to injuries of the chest and head are most numerous in their class ; 
in the Xew Zealand war of England, among the instant deaths, injuries 
of the chest showed 50.00 percent, of the head 33.90, of the abdomen 
9.32. and of the neck and thighs 3.39 respectively. In the Prusso- 
Danish war, of instant deaths, the injuries of the chest take up 50.(15 
percent. tho>e of the head 30.23, of the abdomen 11.37, of the lower 
limbs 3.35, of the neck 2.07, of the back LSI. of the upper limbs 0.51. 
Thus the rates of injuries belonging to the respective localities, arc 
nearly the same in both wars. As the head ami chest contain vital 
organs instant deaths resulting from injuries of these parts are natu- 
rally most numerous. The injuries of the abdomen are indeed like- 
wise apt to be serious, but deaths from them, not being so instant as 
from those of the higher regions, will ensue mostly after some days. 
The cases of instant deaths in the 1st Division of our army in the 
Japan China war may lie arranged as follows : the injuries of the head 
take up 50.42 per cent, of the neck 5.04. of the chest 31.93, of the 



24'2 OX THE BATTLE OF THE YELLOW SEA. 

abdomen 10.92, of the lower limb 1.68, thus only the difference in 
this war is the inversion of the rates of the head and chest injuries, 
all the rest remaining nearly the same in their rates. However, if we 
compute the percentage of Heath of respective regions of 90 instant 
deaths, we see it to be : — 

Injuries of the whole body 33.33 

Head injuries 25.50 

Neck injuries 2.22 

Chest injuries 8.89 

Abdominal injuries 20.00 

Injuries of lower limbs 10.00 

From this we see that injuries so extensive as to affect the whole 
body are most numerous, and that instant deaths from the injuries of 
the abdomen and lower limbs hitherto comparatively few in land war- 
fare, show pretty large figures. This is because in naval battles. 
injuries are mostly caused by shells or their fragments, or large iron 
or wooden splinters, which would inflict cruel injuries by severing 
structures and organs, unlike bullet wounds which merely make small 
perforations for the passage of the bullets. 

The subsequent deaths that occurred during the course of treat- 
ment are 33, the percentage of which according To the respective 
localities is as follows : — 

Injuries of the whole body 63.64 

Head injuries 9.09 

Neck injuries 3.03 

Chest injuries 3.03 

Abdominal injuries 9.09 

Injuries of the upper limbs 3.03 

Injuries of the lower limbs : 9.09 



OX THE BATTLE OF THE YELLOW SEA. 243 

Thus the injuries of the whole body possess the highest rate, next 
come in order those of the head, abdomen and lower limbs which have 
the same rate. When this table is compared with the 73 ' subsequent 
deaths ' which occurred in the 1st Division of our Army in the 
Japan-China war. the different percentages are as follows : the injuries 
of the head Ki.44. of the neck 1.37, of the chest 28.77, of the abdomen 
4 1.09, of the upper limbs 2.74, of the lower limbs 9.59, so that the ab- 
dominal injuries stand highest, and next come those of the chest and 
head, showing a great difference in the order of the proportional ratios 
of the injuries of respective localities. This is because as has already 
been said, in the case of a bullet wound, even in an internal organ, 
the apertures are not large. Unlike shell fragments, a bullet is not 
only very small, but has no irregular angles as the former, accordingly 
death does not follow instantly, but mostly comes gradually during 
the course of subsequent treatment. In the land fights of Europe and 
America in former years, deaths in the course of treatment as a rule 
were most numerous in the injuries of the abdomen, next in those of 
the chest. But viewed merely from the figures relating to deaths 
during treatment, those owing to the injuries of the lower and upper 
limbs were most numerous. This must be attributed to the fact that 
the actual number of injuries was greatest in these regions ; besides, 
on account of imperfect antiseptic methods, various infections resulted 
even in the wounds of the lower and upper limbs, which frequently 
proved fatal. Thus no proper comparison can be made with similar 
injuries at the present day. 

Cases of recovery are 147 and the invalidings alter recovery 28. 
In comparing tlie percentage of the following three results; 'sub- 
sequent deaths' during treatment amount tolo.87, 'recovered ' to 70.67, 
and "invalidings after recovery ' to 13.46. Let us compare this with 



244 OX THE BATTLE OF THE YELLOW SKA. 

those of the Ensrlish army in the CrimeaD war. of which, alone in 
foreign Avars, there exists a report in which this kind of classification 
is made. The wounded rases taken into hospitals were 11,515, of 

which 1.77") i.e., 15.41 per cent, died during treatment. 6,729 i.e., 
58.44 recovered, and 3,011 i.e., 26.15 were invalided. A\ e see that 
the rate of subsequent deaths during treatment is about the same as in 
our service, though the proportions of recovered and invalided are 
different. As rlie art of surgery is now much more advanced than it 
was in the time of the Crimean war. the number of deaths during 
treatment ought to have shown a great decrease in our army. This 
apparent similarity of the death rate is attributable to the difference in 
the nature of the injuries in land fights, and in naval battles on the 
one hand, and on the other to the fact that in our case, those who ex- 
pired soon after being wounded were likewise counted under the 
heading of subsequent deaths, hence this apparent high rate of death. 
Under this heading of deaths, were counted in this table, not a few 
cases that died within twenty -four hours after injury. The following 
shows the time of deaths that occurred within four days of injury, be- 
fore their admission into the Sasebo Naval Hospital thus : 

Those who died on the day of injury '■> 

Those who .lied within one day after injury ... 1 1 

t w< i da \*8 .. .. ... li 

three ... 3 

lour ... 1 

\~ will be seen from this, the 14 who died within 24 hours of 
injury form 42.42 per cent, of the 33 deaths during treatment, and if 
to this be added the 6 deaths that occurred within forty-eight hours 
of injury, we sret 20 deaths, or 60.61 of the total deaths during treat- 
incut. The whole number of deaths that occurred before admission 



OX THE BATTLE OF THE YELLOW SEA. 245 

into the hospital was 24, which is 72. ~'A per cent of the total so 
called subsequent deaths during treatment. The deaths therefore that 
actually took place after admission into the hospital were only 9 (of 
these the wounded men from the Matsushimu were admitted, some on 
the night of the 20th and the rest on the 21st). The conditions of 
the injuries and fatal terminations of the nine cases in the hospi- 
tal were as follows : — 

(a) Cases of extensive burns which extended over two-thirds 
of the whole body were 3, of whom 2 died in three days after 
admission and six days after injury, and 1 died in nine days after 
admission and twelve days after injury, (b) A case of a |>enetrat- 
ing wound of the skull in which a shell fragment pierced into 
the brain above the right frontal eminence. This was superseded in 
its tune by a cerebral abscess and was trephined but with no success. 
The patient died 53 days after the admission and 56 days after injury, 
(c) A ease of a penetrating wound of the chest and abdomen in which 
a shell fragment pierced the chest and abdomen breaking in its course 
the left false ribs, and lacerating the addominal viscera?. The patient 
was already much exhausted owing to traumatic peritonitis when 
received into the hospital, and died five days after reception and nine 
days after the injur v. (d) A. case of a penetrating wound of the ab- 
domen in which a shell fragment pierced into the cavity by the left 
side of the umbilicus, and perforated intestines in several places, caus- 
ing leakage of their contents". This was followed by peritonitis and 
finally the patient succumbed toexhaustion 38 days after the admis- 
sion and 41 days alter the injury, (e) A case of a penetrating wound 
of the sacro-iliac joint in which a wooden splinter got wedged into the 
joint, and reached deep into the pelvic cavity, causing fracture of the 
bones, paraplegia and inflammation of the pelvic organ. The patient 



•24(3 



OX THE BATTLE OF THE YELLOW SEA 



<li( j d from exhaustion thirteen days after the admission and seventeen 
days after the injury, (f ) A ease of compound fracture of the right 
humerus which was progressing favorably and had almost recovered, 
when unfortunately the patient was attacked with erysipelas, to which 
he finally succumbed, 179 days after admission and LSI days after the 
injury, (g) A case of comminuted fracture of the right femur at its 
upper part with severance of soft tissues. Amputation was performed 
at the upper part of the thigh but the patient died from the shock; 
surviving fifteen days alter the injury. The following table shows 
the classification of injuries ending fatally : 

TABLE NO. IX.— INJUEIES WHICH ENDED FATALLY. 



Injuries. 


Instant 

DEATHS. 


Subsequent deaths 


Total. 


Before 


AffEB AD- 






ADMISSION. 


MISSION. 




Mutilation of the whole body 


28 






•28 


Lacerated wounds of various parts of the 
body, and burns of the whole body 


1 






1 


Extensive burns 


1 


18 


8 


22 


Mutilation of the head 


10 






10 


Penetrating wound of the skull 


9 


1 


1 


11 


Perforated wound of the sknll 


1 






1 


Compound fracture of the skull 


1 


1 




■) 


Compound fracture of the facial bones and 
base of cranium 


•2 






o 


Partial mutilation of the neck 


1 






1 


Penetrating wound of the neck 


1 






1 


Perforated wound of the neck 




1 




1 


Partial mutilation of the chest 


2 






•> 


Partial mutilation of the chest and abdo- 










men 


1 




... 


1 


Penetrating wound of the chest 




1 




1 



OX THE BATTLE OF THE YELLOW SEA 



247 



Penetrating wound of the chest and abdo- 
men ! 

Perforated wound of the chest 

Perforated wound of the chest and abdo- 
men 

Partial mutilation of the abdominal wall... 

Mutilation of the abdominal and lumbar reg. 

Penetrating wound of the abdomen 

Perforated wound of the abdomen 

Mutilation of the lower half of the body ... 

Perforated wound of the loins 

Compound fracture of the sacra-iliac joint. . . 

Mutilation of the right side of the pelvis 
and the right femur 

Mutilation of the limbs with the burns of 
whole body 

Partial mutilation of the upper and lower 
limbs with extensive burns 

Compound fracture of the scapula and 
humerus 

Mutilation of the thigh 

Compound fracture of the femur 

Perforated wound of thigh with fracture of 
the femur 

Mutilation of both legs and left forearm 

Mutilation of the leg 

Perforated wound of leg with fracture of 
tibia and fibula 

Total 



... 




1 


1 


4 






4 


1 






1 


2 






•2 


•5 


... 




■5 


3 




1 


4 


2 






2 


2 






2 


3 






3 




... 


1 


1 


1 






1 


1 






1 


1 






1 






1 


1 


4 






* 


1 






1 


1 




1 





1 




1 


1 




1 




1 




1 


90 


•24 


9 


123 



Of the 28 cases of mutilation of the whole body in this table, all except two be- 
longed to the Matsushima, and their limbs and trunks being blown about by the 
explosion of a hostile 30.5 cm. shell, it was impossible to ascertain their identity. 
The names of the killed were ascertained after the investigation later on. Some of 
them are thought to have been blown into the sea through the gun port, but it is im- 
possible to say definitely. 



248 OS THE BATTLE OF THE YELLOW SEA. 

Of the 28 invalided cases, there are from the injuries of the upper 
limbs 10, of the lower limbs li, of the various parts of the body and 
the face 5 each, of the greater part of the body and the head 1 each, 
and the percentage is. 35.71 from the injuries of the upper limbs. 
21.43 of the lower limbs. 1 7 . S (5 of the various parts of the body and 
the face respectively, 3.57 each of the greater part of the body and the 
head, and no invalidings from the injuries of the neck, chest, back, 
abdomen and loins. The proximate causes for invaliding were as 
follows : 

(1) Extensive burns in which atrophy of the limbs and the 
ankylosis of the joints due to cicatricial contraction 1 

(2) Burns of the various parts of the bodv followed by the con- 
traction of the cicatrices 3 

(3) Burns of the various parts of the body followed by obstinate 
eczema owing to the derangement of the nutrition of the 
skin 1 

(4) Burns of the various parts of the body followed by apathy. 1 

(5) Compound fracture of the frontal bone accompanied with 
haemorrhage in the left retina ami resulting in the impair- 
ment of si u'ht 1 

(6) Compound fracture of the facial hone- accompanied with 
detachment and haemorrhage of the retina which resulted in 
the impairment of sight 2 

(7) Contusion of the eyes which caused the haemorrhage of the 
retina and the dislocation of the lens resulting in the impair- 
ment of sight 1 

(<S) Penetrating wound of the eye balls, for which enucleation of 
the one ball was performed 1 



(9 

(10 

(11 
(12 
(13 
(14 
(15 
(16 

(17 

(18 
(19 

(20 

(21 

(•J '> 



OX THE BATTLE OF THE YELLOW SEA. 24 ( J 

Perforated wound of the right scapula, from which impair- 
ment of the movement of the shoulder joint and the atrophy 
of the upper limb resulted 

Perforated wounds of both humeri, in which paralysis of 
the right musculo-spiral nerve followed 

Compound fracture of the right humerus followed by the 
ankylosis of the elbow joint 

Compound fracture of the left forearm, for which the 
amputation of the arm was performed 

Simple fractures of the right forearm and fingers by which 
the grasping power of the hand was impaired 

Mutilation of the right hand for which amputation was 

performed 

Compound fracture of the left hand for which resection of 
the metacarpus was perfi irmed 

Blind wounds of the right arm and the left forearm with 
compound fracture of the right hand, from which resulted 
the imperfect function of both hands 

Compound fracture of the left index-linger which was 
amputated 

Mutilation of the index and middle fingers 

Blind wound of the left thigh which was followed by atro- 
phy, with the mutilation of the right middle finger 

Lacerated wound of the right leg followed by atrophy and 
contraction of the cicatrix 

Compound fracture of the right foot, for which resection of 
the metatarsus was performed 

Sprain of both ankle joints, in which chronic inflammation 
of the joints persisted 



250 ON THE BATTLE OF THE YELLOW SEA. 

(23) Compound fracture of the left knee-joint, for which the am- 
putation of the thigh was performed 1 

(24) Compound fracture of the right knee-joint, resulting in 
ankylosis of the joint 1 

If we compare the rates between deaths and invalidings accord- 
ing to respective regions of injuries, it will lie .seen that their propor- 
tion is reverse, — that is ; the rate of invalidings is small where that of 
deaths is large and vice versa. The injuries of the head. neck, chest, 
hack, loins, and abdomen, were apt to be so serious as to cause instant 
death or death soon after injury, while those which healed were only 
superficial wounds and therefore the number of invalidings was 
small or none at all. On the other hand, in the injuries of the lace 
and of the upper and lower limbs, the rate of deaths is comparatively 
small, and even serious wounds did not prove fatal owing to the 
recent progress in the surgical art, hence the greater number of invalid- 
ings from the resulting impairment of the functions of the injured 
parts. Cases of infections of the wounds were very few and only one 
unfortunately ended in erysipelas. 

The percentage of ' Deaths before admission,' ' Deaths after admis 
sion,' 'Recoveries,' and 'Invalidings,' exclusive of those instantly 
killed is as follows ;- 

Deaths before admission 11.54 

Deaths after admission 4.38 

Recoveries 7U.H7 

invalided 13.46 

These rates will be again taken up after we have finished our 
consideration of the attack on Wei-hai-wei. 



OF ATTACK" OX WKI-H.U-WEI. 



251 



2. OF ATTACK ON WEI-HAI-WEI. 

The number of the shells that hit our ships during the attack on 
Wei-hai-wei was 1 each for the Matsushima, Hashidate, Yoshino, 
Naniwa, Akitsushima, Tsukushi, Fuso, Takao, Katsuragi, Musashi, Ten: 
ryu, and No. 6 torpedo-boat, 2 for the Yamato, 13 for No. !» torpedo- 
boat, and 3 for the occupied Luchotsai fort. Cases of death or injuries 
caused by these shells were 3 in the Matsushima, 7 in the Yoshino. 2 in 
the Akitsushima, 8 in the Tsukushi, 7 each in the Fuso and Katsuragi, 
11 in the Tenryu, 8 in No. !' Torpedo-boat, 7 in the Luchotsai fort. 
Besides these, there was 1 ease in the Katsuragi and ,j in No. 22 
torpedo-boat from other causes. The statistics are shown below. 



TABLE NO. X.— KILLED AND WOUNDED AEEANGED 
ACCORDING TO VESSELS. 



Vessels. 


Fokce ON 

BOAKD. 


Killed. 


Wounded. 


lOTAL OF 
KILLED AND 


PERCENTAGE 
OF KILLED AM 








WOUNDED. 


WOUNDED. 


Matsushima ... 


427 




3 


3 


0.70 


Itsukushima 


364 










Hashidate 


363 










Yoshino 


422 


•2 


5 


7 


1.66 


Naniwa 


361 










Takachiho 


360 










Akitsushima 


323 




■> 


•j 


0.62 


Chiyoda 


315 










Tsukushi 


182 


"i 


7 


H 


4.40 


Banjo 


107 










Maya 


105 










Atago 


106 










Chokai 


105 










Akagi 


128 










Fuso 


11? 




7 


7 


1.69 


Hiyei 


307 










Kongo 


307 










Takao . . . 


228 










Yamato 


•234 




. . . 






Katsuragi 


234 


i 


7 


8 


3.42 


.Musashi 


•234 






... 





(Continued over.) 



252 



OF ATTACK ON WEI-HAI-WEI. 





Force on 

BCAED. 






Total of 


Percentage 


\ 7 ESSELS. 


Killed. 


Wounded- 


KILLED AND 
WOUNDED. 


OF KILLED AND 
WOUNDED. 


Tenryu 


203 


5 


6 


11 


5.42 


Kaimon 


201 










Kotaka 


29 








. . • 


No. 5 torpedo-boat .. 


16 










No. fi „ 


16 










No. 7 „ 


15 










No. 8 ., 


16 










No. 9 „ 


16 


4 


4 


8 


50.00 


No. 10 „ 


17 








. . « 


No. 11 „ 


17 










No. 12 „ 


16 










No. 14 „ 


17 










No. 18 „ 


16 










No. 19 „ 


16 










No. 21 „ 


18 










No. 22 „ 


20 


3 


2 


5 


25.00 


No. 23 „ 


20 










Luchotsai fort ) 
and Landing party) 


62 


4 


3 


7 


11.29 


Total 


6,356 


20 


46 


66 


1.04 



The highest number of killed and wounded shown in table No. 
10, occurred on the Tenryu ; then came the Tsukushi, Ivatsuragi and 
Xi i. 9 torpedo-boat : the Yoshino, Fuso and Luchotsai fort came next, and 
No. 22 torpedo-boat, Matsushiuia Akitsushima last. However, if we 
compare the killed and wounded with the number of the force on board 
the respective vessels, the first in order is No. 9 torpedo-boat, the 
second No. 22 torpedo-boat, the third the Luchotsai fort, the fourth 
the Tenryu. the fifth the Tsukushi. the sixth the Ivatsuragi. the 
seventh the Fuso, the eighth the Yoshino, the ninth the Matsushima, 
the tenth the Akitsushima ; whilst in sixteen vessels, viz. the Itsuku- 
sliinia, Hashidate, Naniwa, Takachiho, Chiyoda, Banjo, Maya, Atago, 
Chokai, Akagi, Iliyei. Kongo, Takao. Vainato. Musashi. Kaiinoii. 
Kotaka. and twelve torpedo-boats no case of killed or wounded 
occurred. 



OF ATTACK OX WEI-HAI-WEI. 



253 



TABLE NO. XL— KILLED AND WOUNDED ARRANGED ACCORDING 



TO RANKS IN EACH VESSEL. 



Banks. 



Vessels. 



fKil 
llnj 

(Kil 
[inj 
| Kil 
llnj 
(Kil 
llnj 
Kil 

I«j 

(Kil 

llnj 

Kil 

Inj 

No. 9 torpedo- f Kil 

boat llnj 

Kil 
(Kil 

Luchotsai fortly • 
(Inj 



Matsusbirna 

Yoshino 

Akitsushiiua 
Tsukushi . 

Fuso 

Katsuragi .. 
Tenryu 



No. 22 boat 

Landing party to 



Total 



fKil 
llnj 



Officers. 



I'ktty Officers, Seamen and 
Non-combatants. 







GQ 




M 


■J3 


3 




K 


* 


£ 






X 






a 








c 


D 


a 




r* 


X, 








■n 





3 

1-2 

3-2 



p 
z 

K 



."> 
6 

1 
4 

3 

o 

4 

3 

'20 
4ti 



254 



OF ATTACK OX WEI-H AI-WEI. 



TABLE NO. XII.— KILLED AND WOUNDED ARRANGED 
ACCORDING TO RANKS. 



U5 

« 




Force 

ON BOAKK. 


Killed. 


Wounded. 


Total of 
killed and 

WOUNDED. 


1 KKCttM- 

AflB OF 

KILLED AND 

WOUNDED. 














3 


Officers 


451 


3 


5 


8 


1.77 


^ 

& 


Engineers 


167 


1 


1 


•2 


1.20 


O 


Surgeons 


45 












Paymasters . . . 


48 




1 


1 


2.08 




Total . ... 


711 


1 


i 


11 


L.55 


m" o: 


Seamen 


8,945 


12 


32 


44 


1.12 


(4 H 

go; 


Stokers 


1,299 


4 


5 


9 


0.69 


2a< 
fa -a f 


Nurses 


5-2 










o z g 


Stewards 


349 




2 


2 


0.57 


s- S o 

- ■< ¥ 

n ^ ^ 


... 


5,6 15 


16 


; !< i 


."> 5 




™ Z 


Grand total... 


6,356 


20 


46 


66 


l.()4 



In the above tables, the highest actual number of killed and 
wounded arranged according to ranks is seamen, next come stokers, 
then officers, engineers, stewards, and paymasters ; no case of 
killed or wounded occurred among surgeons and nurses. Again the 
percentage of the killed and wounded according to the number of 
force in each rank, shows more or less difference in each column as 
shown in the foregoing tables, yet not so great a difference as in the 
battle ot the bellow sea. The killed and wounded in the attack on 
Wei-hei-wai as will be clearly seen from table No. 1">. were most 
frequent among those stationed on the upper decks, while those on 
the lower decks sustained yery few injuries. In the battle of the 
i ellow sea which was an action between vessels, the shells that hil 
the ships' sides were most numerous, owing to the extended low range 
of the projectiles. Thus every part of the ship above the water line, 
whether on the upper or the lower deck, was equally struck, so 
that those stationed on the lower deck were injured as well as 



OF ATTACK OX WEI-HAI-WEI. 



25; 



those on the upper deck. Thus, the number of killed and wounded 
entirely depended on the number of the persons stationed at any place 
that was hit. On the contrary, during the attack on the Wei-hai-wei 
forts, the hostile shells mostly came aboard at an acute angle, accord- 
ingly places above the upper deck were mostly struck ; the only shell 
that pierct-d through the lower deck being one on the Naniwa (the 
shells that struck the torpedo-boats came from the hostile vessels near 
by and are not included in the above). Hence the high casualty 
among those stationed on the upper deck. The unusual high number 
of casualties among the stokers was because No. 9 torpedo boat had 
its boiler broken by a hostile shell during the night attack on Wei- 
hai-wei, S stokers were killed or wounded at one time. 

TABLE NO. XIII.— RATIO OF THE KILLED AND WOUNDED TO THE 
NUMBER OF SHELLS RECEIVED. 



Vessels. 


Number of shells received. 


Eg 




w 


z 

p 


It 


S ; 

- P 

J B 

ri ° 

2 z 

p 

§f 

< 

H 


Is 

- B ; 

2 ° 2 

fa P a 

5 

« fe a 

Bob 



K 





p. 
M 

K 


a 

Eg 


sg 

« B 
Ph 


< 

O 


Matsuslvma 
Hashidate 

Yoshino - 

Naniwa 

Akitsushima 

'I'sukushi 

Fuso 

Takao 

Yamato 

Katsuragi 

Musaslii 

Tenryu 

No. 6 torpedo-boat 

Xo. 9 boat 

Luchotsai fort ... 


1 
1 


1 

1 
3 


1 

1 

1 

1 
1 

1 

1 
13 


1 


13 

3 


1 
1 

5 

4 

4 


3 

5 

2 

7 
7 

6" 

6" 

4 
3 


3 

7 

2 
8 

7 

7 

it 

8 

7 


3.00 
0.00 
7.00 
0.00 
2.00 
8.00 
7.00 
000 
0.00 
700 
0.00 
11.00 
0.00 
0.(32 
2.33 


Total 


9 


20 


1 30 


17 


43 


60 


2.00 



Besides those stated in the above table, there was one casualty in the Katsu- 
ragi and five in No. 22 torpedo-boat, but these were due to other causes than shells, 
hence thev are omitted here. 



256 OF ATTACK ON WEI-HAI-WEI. 

The ratio of the killed and wounded in each vessel, with the 
number of the shells received, was highest in the Tenryu (11.00 killed 
or wounded per shell) ; next came the Tsukushi (8.00); next the 
Yoshino, Fuso, andKatsuragi (7.00 each); next the Matsushima (3.00); 
then in the Luehotsai fortress (2.33); the Akitsushima (2.00); No. !i 
torpedo-boat (0.62), while shells that hit The llashidate, Naniwa, 
Takao, Musashi, and No. 6 torpedo-boat were harmless. Two of the 
shells also that struck the Yamato caused no casualty. The number 
of killed and wounded depends firstly on the explosion or non- 
explosion of the shell, secondly on the place hit by a shell, whether 
the planks, gun barrels, gun shields and other implements were or 
were not smashed to pieces and thrown about. The casualties caused 
by the explosion of shells were on the Akitsushima. Fuso, Katsuragi, 
Tenryu, and in the Luehotsai fort, while in the Matsushima, Yoshino, 
and Tsukushi, they were caused by broken planks or gun shields, and 
in No. !• torpedo-boat by the bursting of the boiler. The relation of 
killed and wounded to the place struck by shell will further he shown 
in the following two tables. 

Of the vessels struck by shells, the I lashidate had the cover of her 
fore torpedo tube damaged by a fragment of shell. The lower deck of 
the Naniwa was pierced in the waist, but happily none of the crew 
of either vessel sustained any injury : the Takao merely had the middle 
part of the main-rigging rent asunder by a shell: the Yamato received 

1 Oo o 

two shells, one on the machine-gun on the ship's bridge, and one in the 
starboard galley ; but fortunately, they did oo1 explode but fell over- 
board, together with the broken iron and wooden splinters, so that no 
person was injured by flying pieces ; the Musashi practically escaped 
injury, for she only had a shell fly over her, tearing the starboard 
main-brace on its way ; No. • > torpedo-boat had its boiler room pierced 
by a machine gun-shot, bu1 none of the crew were hurt. 



ciK ATTACK ON WEl-UAI-WEF. 



257 












■ji 

■ji 



2 



■axri-Ha.LVAV 
3HJ, Aioiay 



•saoaa 
•ayo'i y aire 



'aoau aaaaQ 



•noaa aajjn 
hhx aAoay 



"aMI'I-Ha.LVAV 
aHX A\<i'laj.{ 



saoaa 
•a\ot y ain 






•aoau aa.i.ij 



aoaa aaaaa 

■AHL HAOaV 



aKI'1-HI.IVAl 

aHi Aimag 



saoaa 
aio'i v 'aipj 



?r 



aoaa ;n.i,t j 



■a. Ma aaa^n 
aH.i. aAoay 



— : -m 






■sun-as i.yav 
;ih i. Avcnag 




O 



c3 w: CD 

2 5 5 

S .-t?3 



C 
C cS 



cs : 



o o 
— ^? 
6 6 

' CD QJ 



o o 



a> o o 



:= > ^ < h i =- >- w g h ^ £ 



c 



c o 
S5 rs 



, o 



o 
— 


of 


o 


- 














a< 


.ii 






o 


^1 



.5 o 



3 m 



.3 Z 



« 



c 


c 


1 — 


br 


o 

1 — 1 


sj 




ort 










n 












o 


*^ 




u 










o 


£ 



•258 



OF ATTACK "X WEI-HAI-WEI. 



As will be seen in the table, the parts of the vessels hit by shells 
according to their respective ratio are as follows : the parts higher than 
the upper deck, had the largest number, viz : 14 shells, /.<., 51.85 
per cent of the total number : the middle and lower decks being 
the next, wen' struck by 7 shells, /.<.. 25.93, and the smallest number 
of injuries from shells was sustained by the upper deck viz : 6 
shells, i.e., 'J'2.-'2. while the part below the water line was struck by 
no shell at all. 



TABLE NO. XV.— PARTS OF EACH VESSEL WHERE CASUALTY 

OCCURRED. 







< 

s 

X 

X 

- 

X 

< 



A 

X 
•J. 

: 


< 

X 

X 

=> 
a; 
Eh 

< 


s. 

- 


c 

X 




< 
s 

3 
X 


2 
>• 

Z 

w 


o 

a 
p . 

H •_ 

'<- 2 
6 


< 
.5 

- 

z 




Fore part 








2 


5 


8 






15 


a 


Midship ... 




1 




5 






i 




I'.i 


^ 


After part 






1 












1 


Lower 

DECK 


Midship 








1 






1 




■2 




The fore-castle . . 










•J 








•2 


t \ 


The poop deck .. 






1 










... 


1 


> z 

: -r 


The bridge 


■J 












1 




:■! 




The conning tower 


1 
















1 


- _ 
= a 


Cock pit 














1 




1 


i i 


Engine-room 














1 


3 


1 


£ > 


Boiler room 


3 














5 


5 


Total 


7 


■1 


8 


7 


8 


11 


8 


:.l 



The killed and/rounded of the landing party to tb • Luchotsai fortress and the 
crew of No. 22 torpedo-boat are not enumerated in this table, as they occurred on 
land. 



OK ATTACK OX WEIHAI-WEL 



•259 



The number of the killeil and wounded at each place arranged in 
order of its rate, 35 cases (64.81 per cent.) occurred on the upper deck, 
10 cases (18.52) below the water-line. 7 cases (12.96) above the upper 
deck, 2 cases (3.70) on the Lower deck. Tf we compare these rates 
with the enffaffement of the Yellow sea. we find the rate of casualties 

■ 

agrees only with the cases of above the upper deck, but with the rest, 
the rates are almost reversed — that is to say, the lower deck that had 
the largest number in the Yellow sea has the smallest in this action, 
and that below the water-line which bad the smallest on the occasion 
of the Yellow sea has comparatively a larger number in this, and the 
largest number in the killed and wounded in this action was on the 
upper deck. 

TABLE NO. XVI.— CLASSIFICATION OF INJURIES ARRANGED 
ACCORDING TO LOCALITY. 



Locality of Injury. 


Killed and 

WOUNDED. 


Percentage of killed 
and wounded according 
to respective locality 


Various parts of the body 

The head 

The chest and back 

The abdomen and loins 

The upper limbs 

The lower limbs 


2 

15 

3 

6 

s 

16 


4.00 

30.00 

6.00 

12.00 
16.00 

32.0C 


Total 


50 100.00 



The above table is the classification made according to the locality of respective 
injuries caused by shells, shell fragments and indirect shots snch as iron or wooden 
splinters ; besides these, there were a few others, that is, 1 case each of contused 
wound of the chest, and sprain of the right ankle joint, both caused by the shock of 
the explosion of a shell ; 1 case of contused wound of the foot inflicted by the recoil of 
a gun wheel ; 8 cases of scalds in No. 9 torpedo-boat consequent on the explosion of 
the boiler by a hostile shell. Also 3 cases of drowning and 2 deaths of extreme cold 
.in No. 22 boat, but these are not included in the above table, as they are not caused 
by projectiles and have no relation to the localities injured by projectiles. 



260 oy ATTACK OS" WEI-HAT-WEI. 

In this action, the region with the largest number of casualties 

was the lower limbs, next the head, and last the upper limbs. If the 
injuries be allotted to four localities ; the injuries to the whole body, 
being excepted, — viz : the head, the trunk, the upper and lower limbs, 
we shall see that the head occupies 31.25 per cent, the trunk IS. 75. 
the upper limbs 16.67, the lower limbs 33.33. If the area of these 
localities be considered the head and face occupies 8.51 per cent, the 
trunk 28.91, the upper limbs 21.14, the lower limbs 11.41. so that 
the number of injuries is greatest in the head, those in the other parts 
being nearly in proportion to their respective area. Again, if the above 
figures he added to those of the killed and wounded in the battle of 
the Yellow sea. the head claims N(j persons, i.e.. 34.82 per cent, the 
trunk 54. i.e. 21.86, the upper limbs 4(1. i.e.. 18.62, The lower limbs 
61, i.e.. 24.70, from which we sir that the figures for the head stand 
high. Further adding to these the number of the killed and wounded 
from the shock of the explosion of shell or of firings, we get 95 persons, 
i.e., 34.80 in the head. 58 persons, i.e.. 21.25 in the trunk. 5;! per- 
sons, i.e., 19.41 in the upper limbs, (>7 persons, i.e.. 24.54 in the 
lower limbs. Once more by adding to these 5 cases of burns and 
scalds according to locality, we get 95 persons, i.e., 34.17 in the head. 
58 persons, i.e.. I'd. Mi in the trunk. .">."> persons, i.e., L9.78 in the 
upp.T limbs, 70 persons, i.e.. 25.18 in the lower limbs. I'm the stat- 
istical number of the killed and wounded in the battle of the Yellow 
sea as stated in table 2no. 7 A., and of those at Wei-hai-wei in the 
above table, comprises only one principal injury sustained by an indi- 
vidual in exclusion of all the other minor wounds, bor instance, 
eases in which a more serious wound on the head were classified as 
Such, to the exclusion of many less severe ours on the lower limbs, 
it is not clearly shown which locality really sustained the largest 



OF ATTACK ON" WEI-HAI-WKI. 



26 I 



number of injuries and which the .smallest. To obviate this, the fol- 
lowing table was framed by counting each injury as an independent 
one. whether slight or grave ; according to its locality. 



TABLE NO. XVII. 



Locality 
of injury. 


Battle of the Yellow sea. 


Action of Wei-hai-wei. 


Isjtbies 
bec sited. 


Percentage 
of ikj. according 
to respective 
locality. 


I nj cries 
receh ED. 


PERCENTAGE 

OF INJ. ACCORDING 

TO RESPECTIVE 

L -CALITT. 


The head . . 

The trunk 

The upper limbs 
The lower limbs 


110 

65 

103 

110 


27.92 

16.50 
27.66 
27.92 


29 
10 
23 
39 


29.59 

10 20 
20.41 
39.80 


Total 


394 


100.00 


98 


100.00 



In the reports of the wounded, such statements as ' many or numberless wounds 
were found, so that the real number of injuries can not be ascertained. Such are 
counted as a single wound collectively, to avoid possible error that may occur from 
arbitrarily assigning a number. 

The percentage of the injuries both in the battles of the i ellow sea 
and at Wei-hai-wei as shown in this table, presents following rates : 
the head 28.25, the trunk 15.24, the upper limbs 26.22, the lower 
limbs 30.28. When the injuries of each locality are considered, in 
comparison with the relative area of the whole body, then the percent- 
ages are as follows: the head is 16.33 to 1 unit of area, the trunk 
2.59, the upper limbs 6.10, and the lower limbs 3.60, so that n strik- 
ingly larger rate in the head is followed successively by the upper 
and lower limbs, and the trunk. Viewed in any way, in the late 
naval battle, the head suffered with especial severity. Whether this 
is attributable to the frequency of various projectiles falling from 
above or to some other circumstances, can not easily be accounted for, 
unless further evidence be brought forth. 



26'2 



OF ATTACK O.N" WKI-HA1-WEI. 



TABLE NO. XVIII.— TERMINATION OF WOUNDS IN- 
RESPECTIVE LOCALITIES. 







Killed 1 I, " i " IN 
goursh of 
ODTR1GHT.| tbba .,. MK j, t . 


Recovery. 


In- 
valid- j Total. 

ED. | 


Greater parts nh 
the whole body ) 

Various parts of} 
the body ) 

The head 

The face 

The neck 

The chest and) 
back ) 

The abdomen) 
and loins J 

The tipper limbs 
The lower limbs 


Actual number ... 
Percentage 


7 
63.64 

6 

75.00 

3 

75.00 

4 

66.67 


3 

27.27 

... 
1 
12.50 


1 

y.09 

3 

KKKIll 

1 

12.50 

7 

100.00 


1 

5.26 


11 
100.00 

3 
100.00 

8 

100.(10 

7 
100.00 

4 
100.00 

6 

100.00 

8 
100.00 

19 

100.00 


Actual number ... 
Percentage 


Actual number ... 
Percentage 


Actual number ... 
Percentage 


Actual number ... 
Percentage 


... 


Actual number ... 


1 
16.67 

2 

10.53 


1 

25.00 

1 

16.67 

8 

100.00 

16 

84.21 


Actual number ... 
Percentage 


Actual number ... 
Percentage 


Actual number ... 
Percentage 




Total 


Actual number . . . 
Percentage 


20 

:io :;n 


7 
10.61 


38 
57.58 


1 
1.52 


66 
100.00 



Of tlie terminations of the wounds in the respective regions 
shown in table -No. 18, tlie highest rate of death is in the column 
of ' greater part of the body,' as was the case in the battle of the Yellow 
sea. for the number of the "killed out right' and "died in the 
course of treatment ' added together shows90.91 per cent of the actual 
number, that is 11. of which all hut 1 terminated in death. This was 
because (i eases of scalds of the whole body, - eases of death by ex- 
treme cold and 3 cases of drowning are included in this column. Ex- 
cepting this column, the rate of death for the rest may be arranged in 
order: the head 87.50 per cent, the abdomen and loins 83.34, the chest 

and hack 75.00, the lower limbs 10.53, thus it will he seen the rates 

differ not much from lln.se of the Yellow sea. 

Of 2d cases killed outrighf the percentages of the respective 
locality are thus: injuries of the whole body 35 per cent, of the head 



OF ATTACK ON WEI-HAI-WEI. 263 

30 per cent, of the chest 15 per cent, and of the abdomen 20 per cent. 
Compared with the killed in the battle of the Yellow sen. the order of 
the rates is almost the same in both, except that no injury on the lower 
limbs resulted in death in this action. Moreover if we compute the 
rates of the killed in the battles both of the Yellow sea and Wei- 
hai-wei, the injuries of the whole body constitute 33.64 per cent, head 
injuries 26.36, neck injuries 1.82, chest injuries 10.00, abdominal in- 
juries 20.00, lower limb injuries 8.18; and ir will be noticed that the 
rates show very differently from those of the injuries to the respective 
regions in the land battles before stated. This is because the characters 
of the wounds are different in the two kinds of battle. 

(Refer to table No. 8 about the battle of the Yellow sea). 

The deaths during treatment were 7. of which the percentages of 

injuries in the respective localities were as follows: —The injuries of the 
whole body 42. S5. head injuries 14.29. abdominal and lumbar injuries 
14.29. injuries of lower limb 28.57. However, 6 out of these 7 having 
expired on the day of injury before they had time to be properly treat- 
ed, might well he counted as instant deaths. That is, two died from vio- 
lent shock consequent on scalds of the whole body, one was frozen to 
death by filling into the sea. one died from the crushing of his skull 
by a large lacerated wound of the frontal region, caused by a shell- 
fragment, one died from a wound of the pelvic organ, the ilium having 
been crushed by a large perforated wound, one died from shock owingto 
the multilation ofboth thighs, one died from shock owing to the mul- 
tilation ofboth legs and compound fracture of the ficr, lastly, one ex- 
pired within 24 hours after receiving a severe scald on the whole 
body. Therefore though 7 cases are mentioned of the column of "died 
in the course of treatment.' vet it must be remembered that they all 
died before they could dulv he treated. 



•264 



OF ATTACK: OX WEI-HAI-WEr. 



TABLE NO. XIX.— CLASSIFICATION OF MORTAL WOUNDS. 







Died during 




Name of Wound. 


Killed out 

RIGHT. 


TREATMENT. 


Total. 


Died befohe 


1>IEI> AFTEK 






ADMISSION. ADMISSION. 




Mutilation of the head 


•) 






•2 


Destruction of the skull 


1 


! 




1 
3 


Compound fracture of the skull' 


Penetrating wound of the nkull 


I 






1 


Perforated wound of tli3 chest 


1 






1 


Perforated wound of the chest 










with fracture of vertebrae . . . 


1 






1 


Mutilation of the chest and ab 










domen 


1 






1 


Perforated wound of the abdo- 


men ... 


1 

s 






1 
3 


Mutilation of the abdomen 


Compound fracture of the lum- 










bar region 




1 

1 




1 
1 


Mutilation of both thighs 


Mutilation of both lees 


4 


1 

• ) 

1 




1 
6 

1 


Scalds of the whole bod v 


] » satb by extreme cold 


Drowning 


3 






3 




Total 


•20 


7 27 



As is shown in table 18, thirty eight cases of which were cured 
one was invalided after the amputation of the left foot by Lisfranc's 

in*'! hod. 

The percentages of instant death, death within 24 hours of injury, 
death after 2 1 hours of injury but before admission, death after 
admission into the hospital, recovered and invalided, in the battles ot' 
the ^ ellow sea and of Wei-hai-wei are as follows 



OF ATTACK OX WEI-HAI-WEI. 



265 



TABLE NO. XX. 



Results of the Wounds. 


Actual 
number. 


Percentage. 


Instant death 


110 


30.22 


Death within 24 hours of injury 


21 


5.77 


Death after 24 hours of injury hut before 






admission 


10 


•-'.7.-) 


Death after admission into hospital 


li 


•2.47 


Recovered 


185 


50.82 


Invalided 


29 


7.97 


Total 


M 1 


100.00 



Comparing the above table with 20.00 per ceiil of ' Instanl death,' 
12.33 of 'Death during treatment in hospital,' 4(1.7.5 of 'Re- 
covered,' 20.92 of 'Invalided' as computed by Longmore, we 
find that in this war. ' Instant death ' lias higher rale while ' Death 
during treatment in hospital ' has lower one, and ' Recovered ' has 
larger rate while ' Invalided ' has a smaller ratio. 

TABLE NO. XXL— EESULTS OF TREATMENT OF THE WOUNDS BOTH 

IN THE BATTLES OF THE YELLOW SEA AND WEI-HAI-WEI. 



INJURY. 


z 



B i 

-» 2 

K 


z 

~ -i 
O < 

i ™ 

< X 


< 

.0 


a 

> 

o 

'_ 
a 


a 

> 

z 




■* z 

51 


< * 

- « >;' 
B en 

~: ' ' 

a 1 - 

^ ^ a. 
> s. 

<: o 


Injur: 
Injuries of the scalp . 

Injuries of the skull 

Injuries of the braiu 


9 
3 


l 

3 

1 


15 
3 

4 


17 

15 

o 


1 
1 


1 
4 


1 50 
356 

su- 
ss 


2373 

1 14-00 

14.50 



OF ATTACK ON' WEI-HAI-WEI 



I X J U R V 


z 



< H 

£1 


z 

- < 

< X 

^ = 


< 


c 

a 

> 

a 



a 

< 
> 
z 

— 


- 


'i E 
O K 

X « 

-i 

i- 


X -- 

'•~ z 

•* s ■■ 

H S x 

a 5 a 

is * 

h ~ z 

> i. 
*t 


Injui ■:■-■■. 


2P 


9 






.» 


2,041 




Injuries of Ihe soft part of the face 


19 


2 


21 


■J I 






245 


1 1 r,7 


Injuries of the facial bones 


1 


3 


4 





2 




59(5 


14'J.OO 


rnjnries of the organs of sight 


1 


4 


5 


2 


3 




944 


Is-, S I 


Injuries of the organs of hearing ... 


s 




8 


8 






256 


32.00 




:: 


1 


I 


:; 




1 




11. 2 5 


Injuries of the soft part of the neck. 





I 


3 


3 




... 


163 


5 1 33 


Injuries of important structures ot 
the neck 


1 


._ 


1 




... 


I 


2 


2.00 









15 


11 




I 


1 '53 




Injuries of the thoracic wall & back. 


8 


5 


13 


13 






582 


H.77 


Injuries of the thoracic cavity 


1 


1 


2 


1 


1 


71 


35.1 ) 


Injui as ... 


1 




10 






t 






Injuries of tlie abdoninal wall A 

loins 


3 


2 


5 


5 






320 


64.00 


Injuries of the abdominal cavity 


I 


t 


.") 


1 




4 


185 


37.00 




i'" 


::."> 


55 




lo 


1 






Injuries of the soft part of the 
shoulder 




1 


1 


1 






79 


7:i 00 


Injuries of the scapula 




5 


5 


3 


1 


1 


5 15 


I'i>. ».oo 


Injuries of the shoulder joint 


1 




1 


1 






13 


13 


Injuries of the soft parts of upper 
arm 


1: 


5 


11 


11 






511 


16 15 


Injuries of the humerus ... 


1 


3 


4 


2 


2 




834 


208.50 


Injuries of thfl elbow joint 


1 


1 


2 


2 






21 


12.00 


Injuries of the soft parts of the 
forearm 


6 


5 


11 


11 






557 


50.64 


Injuries of the radius and ulna 




3 


3 


1 


2 




681 


227. 'XI 


Injuries of the sofl parts of the hand 


t 


G 


10 


10 






311; 


31.60 


Injuries of the bom md 


1 


6 


1 


2 


:. 




883 


126.14 



OF ATTACK OX WKI-HAI-WKI 



'Jit 



Injuries of I he lower limbs 


21 


32 


5(i 


11 


7 


:, 


4,271 


T'^.iiT 


Injuries of the buttocks 




2 


2 


2 






111 


70.50 


Injnries of the soft part of the thigh 


6 


5 


11 


11) 


1 




1,040 


9155 


Injuries of the femur 


1 


2 


3 


1 




2 


100 


33 33 


Injuries of the knee joint 


1 


4 


5 


3 


2 




644 


128 80 


Injuries of the soft part of the les? .. 


7 


5 


12 


11 


1 




749 


62.42 


Injuries of the bones of le£ 


3 


4 


7 


4 




3 


255 


3H.43 


Injuries of the ankle joint 


1 


4 


5 


4 


1 




518 


103. '10 


Injuries of the soft parts of the foot 


5 


3 


8 


8 


... 




254 


31.75 


Injuries of the bones of foot 




3 


3 


1 


2 




570 


190.00 


Burns 


23 


2-"l 


IS 


21 


G 


2] 


2,891 


G0.23 


Burns over one-third of the whole 

body 


18 


4 


22 




1 


21 


oil 


41.41 


Burns of various parts of the body 


1 


19 


20 


15 


5 




1,872 


93 60 


Burns of particular parts 


4 


o 


6 


6 






108 


18.00 


Scalds 


:'• 


1 


1 


- 




■ > 


93 


.1 1 .5' 1 


Scalds of a greater part of the body. 


o 




2 






2 


o 


l.oo 


Scalds of various parts of the body. 


... 


1 


1 


I 






90 


90.00 


Scalds of particular parts 


1 




1 


1 






6 


6.00 





1 


1 


2 


1 




1 


-'. 


28 50 


Frost-bite ... ... 


1 


1 


2 


1 


... 


1 


57 


28.50 


Total ... 


128 


126 


254 


185 


29 


40 


15.HSO 


62.52 



As shown in this table, the time occupied in tin' treatment of 
serious eases as injuries to the brain, the neck, cavities of the chest 
and abdomen, the femur, tibia and fibula as well as extensive burns 
and scalds was short, as most of them died soon after injury, on the 
other hand, comparatively long periods required for the treatment of 
extensive burns (more than one third of the whole body); and this is 
attributable to the fact that one case alone took more than 850 days. 
More will be said on this matter in Chapter VI. 



CHAPTER IV. 

CAUSES OF WOUNDS AND THEIR CLASSIFICATION. 

In naval battles, the main cause of wounds is certainly shells, 
luit their effects differ greatly according to the manner in which they 
either do, or do not " explode." or " burst." Resides, the shells them- 
selves, iron and wooden splinters of other things caused by the bursting 
of shells, act as so called indirect shells. Therefore, materials that may 
become the causes of wounds are numerous. Table No. 1 shows the 
classification of different causes of wounds in each ship engaged in the 
\ arious battles. 

Besides the cases counted on table No. 1, There were five 
more deaths due to either drowning, or extreme cold, but causes which 
produced the injuries will, with these five exceptions, be recapitulated 
below from The largest number downward. 

Fragments of the shells 

Explosion of gun powder 

Wooden splinters 

Indirect shots 

Fragments of iron 

Shock of firing and vibration of gas... 

Entire shell or shot 

Shock of explosion of shell 

Steam gushing out of boiler broken by 

hostile shoT 

Fragments either of shells or iron 
Chipped pieces of hardened paint 



149 


cases. 


49 


cases. 


.sc 


cases. 


.'>.") 


cast's. 


34 


cases. 


16 


cases. 


\-J 


cases. 


}'J 


cases. 


8 


cases. 




cases. 


< » 
.i 


cases. 


■) 


cases. 



CAUSES OF WOUNDS AND THEIR CLASSIFICATION'. 0(59 

Fragments either of iron or wood 2 cases. 

Compression between two objects lease. 

Fall 1 case. 

Collision 1 ease. 

Husks of buck-wheat 1 case. 

Smn total 366 cases. 

The above enumeration is reckoned by counting one chief wound 
out of the many smaller ones that each person generally received, for 
we find that the majority had several wounds from different causes. 
Therefore, in order to ascertain the relation between each cause, and 
the variety of wounds, as well as their number, we have to make a 
classification, by treating each wound as an independent one, table 
No. 2 is the classification of causes and wounds, based On the number 
of wounds but not on that of persons. 

From table Xo. 2, we see that the total number of various 
wounds was 629, that by fir the larger part of them was caused by 
the fragments of shells ; for the wounds of this class amount to 45.95 
per cent of the total ; the second cause was ignition of gun-powder 
produced by the explosion of shells, of which the rate of wounds is 
12.56 per cent; the third was tin' metallic indirect sh<>r> caused by the 
explosion of shells, of which the ran' of wounds is 9.54 per cent: the 
fourth was the explosion <it' shells in which the gas and flame from the 
explosive, and iron or wooden splinters as well as the shell fragments 
were the conjoint cause, of which the rare of wounds is 9.38 per cent; 
the fifth was pieces of wood smashed off by shells of which 
the rate of wounds is 9.22 per cent: the sixth was the shock of shell 
explosion by which men were either knoeked down or blown away of 
which the rate of wounds is 3.02 per cent; the seventh was the shock 
of firing and vibration of gas of which the rate of wounds is 2.23 per 



■270 



CAUSES OF WOUNDS AND THEIR CLASSIFICATION". 





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CAUSES OF Wul'KDS AND THEIR CLASSIFICATION. 



271 



: 
— 


Shells 

Bullets 

Fragments of .shell 

Metallic fragments 

Wooden splinters 

Explosion of .shell 

Shock caused by the explosion of shell 

Ignition of gun powder 

Fragments either of shell or iron 
Fragments either of iron or wood ... 
chipped pieces of hardened paint ... 

llu.sk of buck wheat 

Gas produced by firing 

Compression between two objects ... 

Fa 1 

( lollision 

Steam 


i 

00 / 

CO 

-- 
z 

/ ? 






: ■ : : : : : 


en 


: : ic — ' '• £* i-* -a c* «> 


Contusion. 


cn 




Abrasion. 


- 


: :::::: os - 


Grooved wound. 


ti- 




Wounds with 
loss op tissues. 




: :::*-*:: ta h » o : ; 
(-» . — . . tc cn z. cj ci <l • 


Contused wound 


~7 

to 




Blind wound and 

Penetrating 

wound. 


— 


Perforated 
:::::::::o,Shm] wound. 


Cn 


Lacerated 
' - : ic : » : en 5 : o wound. 


cc 

c 




Mutilated 

WOUND. 


~1 

'X 




Burns. 


X 




Scalds. 


at 


::::-:::: .::::::: 


Perforation of 
Membrane 

TTMPANI 


tC 


— — ~t — cn cn — 'i — \ Total. 



- 



272 ' '■' >XTUSIOX. 

cent; the eighth was the fragments either of iron or wood, of which 
the rate of wounds is 2.07 per cent; the ninth is the entire shell (not 
exploded), of which the rate of woundsis 1.91 per cent; the tenth was 
steam and boiling water, of which the rate of woundsis 1.27 percent; 
the eleventh was fragments of either iron or shell, of which the rate of 
wounds is 0.95 per cent; the twelfth was the compression between 
two objects and chipped pieces of hardened paint, of which the rate of 
wounds is 0.48 per cent each ; the thirteenth was by bullets and other 
similar, shots and falls, of which the rate of wounds is 0.32 per cent 
each : the last and smallest was by collision and the husks of buck- 
wheat, of which the rate < if wounds is 0.16 per cent each. Besides 
these, there were 4 persons either drowned or frozen to death and 1 
person frostbitten. 

The wounds arranged in order of their number are contused 
wounds, blind wounds and penetrating wounds, burns, abrasions, con- 
tused wounds, lacerated wounds, perforated wounds, mutilated wounds, 
rupture of tympanic membrane, scalds, grooved wounds, lastly 
wounds of soft parts with loss of substance. The following 
is the description of the relations between the causative objects and 
the wounds. 

1.-C0NTUSI0N. 

(1) Nineteen. cases of contusion were caused by shelJ fragments, 
but the persons actually injured were only 14 in number, as some of 
them received two or three contusions at a time. They were all 
slight cases of ecchymosis or small hematoma. A few cases of some 
interest will be given below : — 

1st example. — Case of contusion of the chest attended by simple fracture ol 
cartilage oi the left 3rd rib. This healed in due time with no signs of injury to the 
internal organs nor any other had sequence. (See clinical history No. ■-!''. I 



coxtusiox. 273 

2iul example. — Case of contusion of the upper part of the right arm, where the 
skin was abrased, with ecebymotic swelling extending to the shoulder joint with the 
interference of its movement requiring more than three months before recovery. 
(No. 197.) 

3rd example. — In this instance, the injured person was struck on the right in- 
guinal region by a shell fragment. 

As he had, however, a leather tobacco pouch and a pipe of German silver in the 
pocket of his coat, the fragment tore the pouch as well as the coat, and bent the pipe 
into a shape like this — " { — ," and stopped there. So happily there occurred 
nothing more than a contusion with subcutaneous extravasation of blood. Had it not 
been for the pipe, there would certainly have occurred a serious penetrating or per- 
forated wound of the abdomen. (No. 135. ) 

4th example. — Case of contusion on the 3rd and 4th ribs in front of the chest, 
which caused extravasation of blood as large as the palm of the hand attended with 
marked swelling ; and then with spitting of blood, cough, sharp pain on deep inspira- 
tion. Crepitations also were heard in the neighbourhood yet no symptoms of injury 
to the libs or cartilages could be seen. When he was admitted to the hospital on the 
10th day after his injury, the spitting of blood had already ceased and no abnormal 
conditions of the heart, lungs, and pleura were detected. He recovered before long. 
Probably there had been some contusion of the lung though the ribs were not hurt. 
(No. 257.) 

Fighting w'th such weapons as arc made use of at the present 
day. we can readily see that materials driven about in a warship such as 
shell fragments are surprisingly numerous. For instance, the fragments 
that were found lying about in the Hiyei only, were abundant enough 
to till a Large chest. At first sight, it might naturally he expected 
that so large a number of fragments flying in a vessel would cause 
a great many cases of contusion as the surface of these fragments is 
often blunt and their velocity is generally somewhat impaired before 
they strike. ^ et the tact is cpuite the contrary. The total number of 
various wounds produced by shell fragments was 289 as is shown in 
table No. 2, of which contusions numbered not more than 19. giving 



•274 CONTUSION. 

• ;.. r >7 ]>er cent of the total. This comparatively small number of 
contusions is due to the fact that in naval engagements, fragments 
coming in from the shells that exploded at a distance arc very few, 
the shells mostly exploding after they have struck the vessel ; and 
further, that the fragments generally injure persons at or about where 
the shells burst or exploded, for the fragments are prevented from th- 
ing about by strong walls and ether obstacles abundant in vessels. 
Though these fragments may not be so powerful, yet are strong 
enough to inflict other kinjs of wounds than mere contusions. Thus 
cases arc very rare in which the fragments already weakened by col- 
liding against various objects hit human bodies so as to produce only 
contusions. Moreover, fragments are of irregular shape having acute 
points and sharp edges, so that when they strike human bodies, they 
are apt to break the skin and inflict more than mere contusions. 

(2) The number of contusions produced by the blows of metallic 
fragments were five, one to each person wounded : 3 being struck by 
broken pieces of gun-shield, 1 by some other iron-fragments and 1 by 
the broken piece of a brass rail. Each was a simple case merely 
attended by extravasation of blood, and none presented any feature 
worthy of special record. 

It is a matter of course in naval battles that iron or other metallic 
fragments broken by hostile shells are driven about in all directions ; 
yet it is likewise certain that ceteris paribus these fragments are far 
weaker in force than the fragments of the shells themselves — especi- 
ally so in the case of an exploded shell. For when a shell strikes 
metallic substance, the former first loses more or less of its original 
force according to the degree of resistance offered, and further, it 
imparts part of the already weakened force to metallic fragments 
which thus obtain their motion, therefore the metallic indirect shota 



COKTUSIOX. 275 

which, whatever be their size, have a much smaller velocity, should 
produce more cases of contusion. But, in point of fact, there occurred 
only 5 cases of such injury, giving only a ratio of 8.33 per cent of 
the total number of 60 rases of various wounds attributable to the 
same cause. This compared with the ratio of cases produced by shell 
fragments is only a trifle larger. However, this was not a mere 
matter of chance. ■ It is true that the detached pieces of metallic 
materials were much weaker in force than shell-fragments, hut they 
scarcely ever flew to any great distance and mostly injured persons 
at comparatively short distances, so that they could inflict wounds 
other than contusions ; the more so, as they had the same irregular 
points and edges as the shell-fragments. 

(o) The number of contusions owing to blows from wooden 
splinters was 17 for 14 persons. In most of these cases, there <»■- 
curred no more sequences than extravasation of blood and swelling, 
and mostly recovered in a few days. A few cases of some interest 
are given here : — 

1st example. — Case of contusion on the right forearm and hand by broken 
wooden pieces. When the patient was admitted to the hospital after four days of 
injury, the forearm was found swollen, and a fracture of the ulna was recognised 
at the juncture of the middle and lower third. A contusion on the back of the ring 
and little ringers on the same side with fracture of the first phalanx of the ring 
finger was also detected. The forearm and hand were fixed by plaster of Paris 
bandages, and in a month the fractures were united, but the movements of both 
ringers were impaired tor ever and the man was invalided. ^Xo. 223.) 

2nd example. — Case in which the forearm and hand, and the outer side of tie 
leg on the right side were struck by wooden splinters. There resulted extrava- 
sations of blood and swelling in the parts struck and a fracture of the head of fibula. 
A splint was applied to the leg and the ease healed in a month. (No. "284. i 

3rd example. — Case in which the right upper eye-lid was abrased, attended 
with contusion of the ball ; the conjunctiva was congested and there was an extra- 



276 CONTUSION 

vasation of blood into the anterior chamber, so that the sight was much impaired. 
The extravasation in the anterior chamber was absorbed and the congestion of the 
conjunctiva disappeared in a i>"x days, yet when the injured man gazed at any 
object ; a mist seemed to float before the eye, s i as to obscure the sight, and finally 
sight external strabismus resulted. (No. 108.) 

Wooden splinters often served as indirect shots as well as iron 
fragments. Compared with iron fragments, the wooden .splinters are 
much lighter accordingly the hitter should ceteris paribus be much 

weaker in force than the former. It is true that a shell lireaks wooden 
material more easily than iron and thus its force being far less reduced 
when it .strikes wood, it seems probable that somewhat greater motion 
will lie given to the wooden splinters, hut as a rule they are much 
weaker in force than iron pieces, for there is a great difference in 
weight. Wooden splinters therefore will naturally produce more cases 
of contusion than the fragments of iron or shell and of the Total 58 
various cases injured by wooden pieces. 17 were wounds of this class, 
giving a ratio of 29.31 per cent of the total, which is, as it should be, 
far larger than that either of shell fragments or of iron-pieces. 

(4) Fourteen cases of contusion caused by the shock of shell 
explosion occurred for ten person-. 

1st example.- -In the Matsushima, much ammunition exploded in consequence 

of the explosion of a hostile shell, and the shock threw the man backward, thus causing 
injuries on the back part of the parietal region, the right shoulder, and tic right elbow 
joint. He fell into unconsciousness at the time, hut coming to himself after a while. 
was engaged in putting out the lire. But the contusion at the elbow joint proved 
rather serious, being followed by a marked swelling, and needed hospital treatment. 
(No. 211.) 

2nd example — The same shock blew a man into the air, causing a sprain of the 
ankle joints and concussion of the spine The ankle joints and the dorsa of the feet 
were great!} stt illen and discoloured, followed 1>\ tlia paraplegia of the lower limbs 



CONTUSION. -277 

and tenderness at tlie lower lumbar vertebra. The patient left the hospital much 
relieved after a treatment of three mouths. (No. 100. 1 

3rd example. — A case of sprain of the ankle-joints as well as of the tarsal joints 
from the same cause. The patient could not regain the power of walking after nine 
months' treatment in the hospital, and thus lie was placed on the invalided list for 
life. (No. 293 

4th example. — By a violent vibration caused by the explosion of a hostile shell 
on the Hivei. a man was knocked down and sustained a sprain of his right ankle 
attended by the fracture of the outer malleolus and a partial dislocation of the joint. 
He was treated in the hospital for three months and left almost recovered. (No. 290. 'i 

5th example. — At the same moment, a man was thrown down from the bridge 
against the rail and received a contusion on the right clavicle attended by a fracture 
of the bone. He recovered in a month. (No. 188.1 

6th example. — At the Luchotsai fort, a hostile shell exploded at a distance of two 
meters, and by the force of the explosion gas, a man was thrown down from ti 
citadel and had his ankle joint sprained. He recovered after a month of hospital 
treatment. 

Besides these, there were cases of contusion on the right shoulder and the right 
side of the chest and of sprains of the tarsal-joiuts, hut they are nut worthy of being 
specially recorded here. 

The .shock produced liv the explosion of a shell is, extremely 
violent. For instance, when a 30.5 c. m. shell exploded on the fore 
part of the lower deck of the Matsushima and set large amounts of 
gun-powder on fire, nor only was the upper deck terribly shaken hut 
it was bent like an arch and rent wide o>>en. Again when a 30.5 c. 
in. shell exploded in the wardroom on the lower deck of the Hiyei. 
the corresponding portion on the upper deck was raised four or five 
inches, and the mark was clearly to lie seen afterwards on the stan- 
chion. The shock being SO sudden and violent, the persons present are 
generally thrown down, or precipitated, and thus tire liable to contusion 
by strikng against other things. Fourteen cases out of ninteen injured 



oys CONTUSION. 

in rhis way were contusions, showing ;i ratio of 73.68 ]kt rent of the 
total. In this class of wounds there occur not unfrequenltv rases. 
such as severe sprains of the ankle joint, or the concussion of spine 
which delay recovery for many weeks. 

(5) The cases of contusion owing to compression and falling 
are three : one is an instance in which a man was thrown down into the 
engine room bv the shock caused hv the discharge of the gun, and 
tainted from a blow on the chest : but almost immediately came to 
himself without any signs of fracture or injury to internal organs; 
one is an instance in which a man had his left foot squeezed by the 
recoil of a gun wheel which caused extravasation of blood on the dorsum 
of the foot, and the third was a case in which a man while carrying' ., 
torpedo slipped down on the deck on his right hand so hard that the 
first phalanx of his right thumb A\as fractured. 

((i) A case occurred of contusion of doubtful origin on board 
the Akagi. While he was firing on the starboard side of the bridge in 
the battle of the Yellow sea. a 1") c. m. shell came from the stern, and 
passed about a toot in tront of his eves and burst against the gun 
support. The shell fragments inflicted several abrasions and contu- 
sions on the outer part of the left clavicle and of flic lower limbs. 
From this time, his eye sight was lost, hut no marks of contusions etc. 
were to lie seen either on the eye-lids, nose, or face, though there was 
a congestion of the ocular conjunctiva without any sign of the intru- 
sion of foreign bodies into the eye hall. \\ hen he was admitted to the 

hospital, four days otter the accident, the conjunctivae of both eyes were 

inflamed, the cornea of the right eye was cloudv so that he could not 
tell light from dark, and acute pain was fell in both eyes. When the 
eyes were exaini lied a few davs afterwards, conj unctivitis of the rigb.1 
eve persisted with ciliary congestion, the cornea was somewhal turbid, 



COXTUSIOX. 079 

the iris exhibited a serrated appearance :it its upper edge producing 
posterior synechias, the lens was partly dislocated towards the nasal side. 
and presented a grayish opacity, the eve-sight was entirely lost. As to 
the left eye, there was apparently no change, yet on examination of 
the fundus, detachment of the retina with haemorrhage was found : also 
entire loss of sight. After many months of treatment in the hospital, 
the wounds in the various parts of the body were already healed, and 
the inflammatory symptoms of the eye had disappeared, but the sight 
was lust forever. He was therefore invalided for life (Xo. 107.) 

How this contusion of the eye-balls was occasioned is inexplicable 
considering that the broken pieces of the shell had passed one foot in 
front of the face ; and again taking it for granted that the eve-balls 
were hit by some of the pieces, it is equally strange that the eye-lids 
and the bridge of the nose were left uninjured • for it is quite inconcei- 
vable that when both eves were contused by broken pieces of a shell. 
the bridge of the nose King between them should escape without sus- 
taining even a slight contusion. The riddle could be solved if we 
could assign the cause to explosion gas. from which the skin of the 
face might have sustained no injury whilst the sensitive and delicate 
eye-balls did. But the fact that the shell did not explode but was simp- 
ly broken, is so certain on investigation that no doubt can be enter- 
tained on that point. Then, could the theory of "a wound from the 
wind of a ball which prevailed in former days be trusted, the present 
'•use could easily be explained. According to that theory, the shell 
forces its way through the air. so rapidly that if produces cither a vio- 
lent centrifugal vibration around the shell or centripetal vibration of 
the air just behind it. as the air around rushes in to till the vacuum, 
[fa man be struck by this violent vibration of the air. the skin may 
escape from injury, yet internal organs will be hurt by compression. 



280 CONTUSION. 

However, the absurdity of the wind-ball theory has been made so plain 
by facts and experiments, that there is scarcely left ground for harbour- 
ing any belief in if. and so the present case can not be considered as 
an instance of the so called wind-ball wounds. Besides, durinsr the 
late war there were many instances in which no injurv was sustained 
in spite of the dose passage of shells. In default however of a clearly- 
ascertained evident cause tor this case, we can venture <>n a supposition 
by taking into consideration the circumstances at the time of injurv. 
Several persons who were engaged in firing the same q. f. gun were 
all seriously wounded at the same moment. One had both his thighs 
nearly severed, and was thrown down into the hammock netting by the 
shock, and died instantaneously. The second man was also killed - on 
the spot having the pelvis and right thigh multilated. The third man 
sustained a perforated wound on the left shoulder and a penetrating 
wound on the neck. The last, two men and the person now in ques- 
tion were found stretched on the deck and groaning. From these 
considerations we infer that the injured man in question may reasonab- 
ly have received contusion of the eye-balls by colliding heavily with 
one of the other wounded persons, or by being struck on the face by a 
limb or the bodv of another. It is true that this theory can not be 
supported by evidence as the injured man did not remember the con- 
ditions at the time of injury; hut seeing that there was left no trace of 
lesion on the lace, we can not hut infer that the eyes were heavily 
com pressed or hit hv something soft. 

Resides the above, among those killed instantaneously on hoard 
the Ilivei and Matsushinia, there were cases oi serious contusion in 
which though tin' skin remained intact, yet the sofl tissue.-, beneath 
were extensively reduced to a pulpy mass and the hone pulverized, so 
thai when the pari was touched it gave the sensation ol touching an 



ABRASED WOUNDS. 28] 

ice-bag. Such cases were noticed by the surgeons concerned, but they 
were so busily engaged in the treatment of the wounded that they 
could not afford to do more than merely record the wounds deemed 
to be the chief cause of death. These wounds however were mostly 
on the thighs, and were probably caused by blows from the obtuse sur- 
face of large shell-fragments or of pieces of iron or wood. 1 liese 
wounds are not unfrequently met with in naval warfare, and it must 
have been a matter of mere chance, that no instance; of this kind oc- 
curred among the wounded persons who remained alive at the end of 
the action. 

As we have above mentioned, there are 59 cases of contusion, ol 
which 11) were caused by the shell-fragments ; 5 by metal fragments; 
17 by wooden splinters ; 14 by blows sustained from being knocked 
down by the shock of shell-explosion ; 3 by compression or fall owing 
to the shock of firinsr ffuns, and 1 the cause of which has not been 
ascertained. 

In naval battles, it is natural that a, great many injuries should 
lie occasioned by the above enumerated causes. Notwithstanding this 
fact, 59 cases of this class show a ratio of only 9.38 per cenl nut of 
629 cases of all injuries ; — a ratio much less than might have been 
expected. But tins is probably owing to the fact that serious con- 
tusions accompanying other fatal wounds were not r< rded, and also 

that cases of slight contusions escaped notice as they were not re- 
ported for treatment. 

2. ABRASED WOUNDS, GUTTER WOUNDS, WOUNDS 
ATTENDED WITH LOSS OF SOFT TISSUES. 

Abrased wound is the general Term including all that class of 
injuries in which the direction of the shell-fragments is almost 



•282 ABRASED WOUNDS 

parallel with the surface struck, so that only the epidermis or a piece 
of tin' skin is stripped off. 

Those wounds which expose the subcutaneous or muscular tissues, 
yet do not resemble the gutter wound, are also enumerated in this 
category. " Gutter wound " is the appellation for those wounds 
produced by the same cause as above, in which the tissues were lost 
in a long, narrow shape tormina' a groove. " Wound with loss of 
soft tissues ; ' is the general name for wounds in which both the skin 
and other soft tissues have been extensively lost from the same 

causes. 

(1) The abrased wounds due to the fragments of shells num- 
bered 47 in all, occurring in 30 persons. None of them presented 
interesting phases worthy of special record, as they wen' all healed 
in a few days ; and with those wounds which were rather deep there 
were none with a surface clean cut as by a sharp blade, but. mostly. 
the tissues of the surface were irregfularlv contused with more or less 
extravasation of blood around them. Of the 289 cases of all kinds 
of wounds caused in this way, this class shows a ratio of 16.26 
per cent. 

(2) Abrased wounds produced by iron-fragments were 10 for 
'.» persons, all of which were a light nature ami need no special 
record ; the ratio is lli.l>7 per cent of ti' 1 wounds produced in this 
way. This is almost the same as the ratio (if the wounds occasioned 
by shell-fragments. 

(3) Abrased wounds inflicted by wooden splinters numbered 1 •"> 
occurring in 8 persons ami were all light. They hear a ratio of 22. 1 1 
percent out of 58 wounds, the total produced bv the same cause, 
ami the ratio is comparatively a little larger than those of shell- 
fragments ami iron-pieces. This is probably attributable to the tact 



ABRASED WOUNDS. 283 

that the wooden spliaier which is not so heavy is apt easily to deviate 
its course when it hits an object ; and can give no further injury than 
the present kind, even if it strikes the tender skin at an angle of 
which other missiles as shell-fragments or iron-pieces would have pro- 
duced wounds other than mere contusions. 

(4) Besides those mentioned above, there were two cases in 
which it could not be ascertained whether the injury was caused by 
a shell-fragment, iron-piece, or a wooden-splinter ; and three cases 
in which abrasion of the skin of the face was due to blows of flying 
pieces of paint. 

Abrased wounds numbered 7."> in all ; and this seems to be 
rather numerous compared with the number of contused wounds, 
considering that the glancing of missiles from surfaces almost parallel 
with their direction (which is the cause of the abrased wound) must 
be by far less frequent than their impact against surfaces lying at 
right angles to them which is the cause of contused wounds. I Jut if 
the 85 cases which form the total of the injuries in question, and of 
gutter wounds and wounds with loss of tissues occurring from iden- 
tical causes, be compared with the 413 cases, which form the total of 
the various wounds produced by missiles striking the skin at a right 
or obtuse angle, the ratio will be seen to be no larger than 1 to 5, 
which can not be said to be disproportionate. Moreover, as not :i 
few shell-fragments and iron-pieces take a slanting direction in com- 
ing down, it may reasonably he expected that they will in many cases 
merely graze the skin. Again, in the time of battle, surgeons are 
often too busy fully to study the nature of each wound and abrased 
wounds may be hastily classed amongst' contusions, and vice-versa. 
The records are necessarily brief and discrimination is often very 
difficult. 



284 U'.KASED WOUNDS. 

(5) The gutter wound : — 6 cases in all occurred in 6 persons, 
each caused by a slanting blow from a shell-fragment. 

1st example : — The injured man sustained a wound 3 cm. long and 5 mm. wide 
reaching tin' subcutaneous tissues, running inwards and downwards at the part above 
the left patella and attended with a contusion of the tissues around the margins of the 
wound. (No. 253.) 

2nd example : — The injured man received a wound f) cm. in length, 4 cm. in 
width, and 1.5 cm. deep, on the back of the lower part of the left forearm. The 
margins of the wound were markedly contused, and the surface irregular. It was at 
last cured after treatment for 4 months. (No. 219.) 

3rd example : — In this case the injured man received a wound 3 cm. long, 1 
cm. wide, and 1 cm. in depth in the left parietal region running to the right and 
towards the back ; the margins were torn and ragged, and an irregular shell-fragment 
the si/e of a pea was lodged in the wound. It was healed alter treatment for 3 weeks. 
(X,.. 43.) 

4th example. — The injured man sustained a wound 3 cm. in length, J. 5 cm. in 
width and reaching the subcutaneous tissues, on the ulnar side of the upper third of 
the right forearm. The margins were bruised. It was completely healed after treat- 
ment for :; weeks, No. 218.) 

•5th example : — The injured man received a wound running laterally at the supra 
spinous region of the right scapula. It was 8 cm. in length and 3 cm. in depth, and 
the margins were sharp : sutures were tried, but the wound suppurated and took 70 
days to heal. (No. 191.) 

6th example : — The injured man received a wound in the anterior surface of the 
lower third of the right arm. It had a length of 4 cm. and a width of 1.5 cm. and 
was 1.2 cm. in depth: the margins were sharp, the bottom irregularly lacerated. 
Hi. wound was healed after a month, i No. 203 

Each of the above 6 cases of gutter wounds had an irregularly 
lacerated surface with bruises around it. and there was no1 a single 
case which looked as if a slice had been made by a keen blade as 

is often the case with bullet-wounds. Accordingly, though hasmor- 



WOUXDS WITH LOSS OF TISSUES. 055 

rhage was not copious the healing process was slow, and compara- 
tively a long time was required for the treatment. 

(6) W ounds with loss of tissues are 4. one caused by the slant- 
ing blow of a shell : the other three by fragments of sbell. 

Tlie wound caused by a shell was a large one, extending between the crest of the 
right ilium and the costal arch, and covering an area 15 cm. in transverse and 9 cm. 
in vertical diameter. The soft tissues were torn off in an oval shape leaving an 
irregular bruised margin. A few days after the injury, which was sustained on Feb- 
ruary 7th, the skin around the wound became sloughy and the wound suppurated. 
At the time of admission to the Sasebo Naval Hospital, the wound had increased in 
size, but under treatment, it gradually improved, the granulation looked healthy and 
the wound was progressing favourably, when on June 10th, the temperature suddenly- 
rose to 3S\4 C. attended with chilliness, and the wound showed two yellow patches 
each about the size of a two sen copper and speckled with blackish spots The dis- 
coloured granulation was then examined under the microscope, and numerous strep- 
tococci were noticed. The discolored parts were painted with a 10 per cent solution 
of carbolic acid, followed by a wet carbolic compress saturated with 3 per cent solution. 
On the 11th, the temperature became normal, and the discoloration somewhat abated. 
The former treatment was continued, and by the 14th, the granulating surface was 
restored to healthy state, not a single coccus being visible. However, on the 19th, 
the same discoloration again set in, attended by pus discharge, rise of temperature 
and growth of streptococci. S:> the same treatment was repeated which restored the 
granulation to a healthy condition on the 24th. From that time the healing was 
rapid and on July 12tb. 4 pieces of skin were grafted, and the wound was completely 
healed on August 23rd. (No. 159. 

The 1st case : The wound caused by shell-fragment was an injury which carried 
off the skin and muscular tissues over an area 18 c m. long and 12 c. m. wide on the 
calf of the right leg. At the bottom of the wound, a deep muscular layer was exposed 
but the posterior tibial artery fortunately escaped injury. The hiemorrhage was 
slight, but in addition to the above wound, the man had sustained a perforated wound 
in the lower part of the left thigh. At the time of admission to the Sasebo Naval 
Hespital. the wound suppurated, the bruised tissues became sloughy, and the pain 
was intense. On the 28th of the same month, the mortified parts came entirely off, 



■2>i\ WOUNDS WITH LOSS OF TISSUES. 

and the surface became clean. The subsequent course was favourable and it was 
perfectly healed on January 15th of the following year by cicatrization. The hip 
and the knee joints, however, aukylosed at an angle of about loCP, and the swelling 
and numbness of the foot remained. Local bathing, massage, and forced extension, 
were resorted to, and the numbness was gradually relieved ; but as his walking power 
was not sufficient for him to return to active service, he was discharged on April 
19th. (Xo. 279.) 

2nd case : In this case a wound of 10 c. m. square was iuflicted on the inner 
side in the middle of the right thigh ; the whole layer of the skiu was carried off, so 
that the areolar tissues were exposed ; the wound surface and its margins were irre- 
gularly torn and bruised. The wound suppurated afterwards. The case was also at- 
tended with a blind wound in the upper part of the same thigh. However, it made 
favorable progress, and was cured on October 28th. (Xo. 25 I 

3rd case : In the present case, the skin and muscles at the middle of the outer 
side of the left leg were carried off over an area of about 6 c. m. square attended with 
a large perforated wound in the abdomen. The injured man died 7 hours after the 
injury. (Xo. 173.) 

The four cases of wounds with loss of tissues above stated, natural- 
ly belong to the same category with the abrased and gutter wounds, 
yet on account of the extensive area of the injured parts owing to the 
large size of the projectiles, there was a great difference in severity 
compared with the other two. Especially with the case which was 
caused by an entire shell, the injury was naturally serious. It was 
produced by the compression of the skin against the rounded lateral sur- 
face of a shell, which, though it would not as a rule tear open tissues, 
yet owing to its weight and subsequent force, exerted a pressure strong 
enough to rend and crush the tissues. Thus the injury was not limit- 
ed to the part torn, but the surrounding tissues were extensively con- 
tused. The healing process was accordingly slow, occupying a 
comparatively long time. The 2nd case was produced by a shell- 
fragment. Judging from the area and depth of the injury, it must 



CONTUSED WOUND. 287 

surely have been a large fragment, though certainly not so large nor 
so heavy as the entire shell. Its force therefore, as compared with the 
force of the entire shell 'vas probably weak, but as it was a fragment 
with probably an irregular shape and keen edges, it may have destroy- 
ed the tissues not only by pressure but also by laceration. According- 
ly, in this instance the tissues around the wound suffered contusion 
indeed, but ir. was slight as compared with the 1st instance, and in 
spite of the size and depth of the wound, a much shorter time was 
required for recovery. 



3.-C0NTUSED WOUND. 

(1) The contused wounds caused by shell-fragments numbered 
97 in all occurring in 59 persons of which interesting cases are as 
follows : 

3. — Iu this case the injured man was struck by a fragment of shell and received 
a contused lacerated wound on the outer side of the lower third of the left thigh. On 
the skin there were 3 lacerated holes, each of the size of one sen copper, the femur 
being broken at the same time ; besides, consequent on the explosion of gun powder, 
he sustained burns over a large part of the body. These injuries proved fatal to the 
patient on the day following. (No. 323.) 

b. — In this case, the injured man had the '2nd phalanx of the left index fiuger 
crushed by a shell fragment ; the soft tissues were greatly damaged, and the bone was 
smashed. He sustained also burns over a larger part of the body. After admission 
to the hospital, the injured finger was cut off at the 1st phalangeal joint, and owing 
to the loss of the finger he was dismissed from service. (No. 241.) 

C. — The injured man had the squamous portion of the left temporal bone broken 
by a shell-fragment, accompanied by burns of a greater part of the body. At the time 
of injury he was unconscious, and though he was brought to himself after a while, yet 
the intense pain gave him extreme agony to which he succumbed on the following 
day. Death was due to concussion of the brain but the chief cause of death was the 
extensive burns. (No. 324.) 



•288 CONTUSED WOUXD. 

(j, — This was a case of a contused wound 5 c. in. square rent open in a star like 
shape, at l! cm. below the spinous process of the left scapula, together with small con- 
tused wounds on tbc outer side of the left little toe, and on the inner side of the rigid 
great toe. 'the contused wi und on the scapula reached deep, so that the finger, if insert- 
ed, directly touched the bone, which was however found intact. The wound canal took 
an upward and outward course for 4 cm. in depth. After a time, the wound fell to sup- 
puration, and pus was accumulating at the lower part of the wound, where accordingly 
a counter opening was made to facilitate its evacuation. However, the healing process 
was unfavorable, and on October 12th, the temperature suddenly rose, and in spite of 
the slight discharge of pus, the margins of the wound became congested and signs of 
erysipelas appeared. The temperature reached 40°. C. and the local inflammation 
extended somewhat, hut on the 26th the signs entirely disappeared and the wound was 
completely healed on November 14th. I No. 190.) 

g. — Ibis was a case of large contused wounds attended with fractures in the mid- 
dle of the right upper arm, and of the lower part of the left thigh, and of the left leg : 
besides, there was a perforated wound of the abdomen. The injured man died on the 
spot, i No. 165.) 

f — Ibis was a case in which a contused wound 3 cm. long was sustained on the 
left parietal region. The margins of the wound were irregularly torn, and its depth 
reached the bone ; the pericranium was detached and the outer plate broken, but 
happily no signs of compression or of injury to the brain substance were present. In 
the course of time, a free piece of bone at the bottom of the wound was removed, and 
from that time favourable progress was made until it was completely healed on De- 
cember 10th. (No 48.1 

n. — This was a case of a contused wound on the inner side of the lower-third ol 
the right thigh. There was copious bleeding owing to the injury of the femoral artery. 
so one of the carriers of the wounded man stopped the haemorrhage by a compress 
bandage and carried him into the surgery in the wardroom at the rear of the lower 
deck. He was being attended by the surgeon, when unfortunately a hostile shell ex- 
ploded in the room and mutilated his chest and abdomen so that he died instantly, 
i No. lot. I 

h. — This was a case of a carrier of the wounded who brought the man above 

mentioned to the surgery when a fragment of shell gave him a seven Contused wound 

tof lie fae,- with a fracture of the base of skull ; he died on the spot. (No 58 I 



CONTUSED WOTJXD 289 

j — This was a case of a small contused wound in the upper border of the right 
temporal region ; it reached the hone but without any lesion to it. However, after a 
time paralysis of the left fingers supervened, which persisted after the healing of the 
wound in three weeks. (No. 41.) 

|( — This was a ease of a contused lacerated wound 6. cm. long and 3 e.m. 
wide extending from the left side of the forehead to the vertex and causing fracture of 
the skull, and injury to the brain. In addition, he sustained another wound 24 cm. 
long and 9 cm. wide on the outer side of the left leg and many others of the same 
description on the face, chest, and the limbs. The injured man died instantaneously. 
(No. 51.) 

|_ — This was a case ofa contused lacerated wound 15 c m. long and 6 cm. wide 
extending from the middle of the forehead to the vertex. The cranium was smashed 
and the brain injured ; besides, he sustained a contused wound in the middle of the 
right upper arm and on the back of the elbow joint of the same side, attended by the 
fracture of the bone. The injured man was unconscious and died soon after the in- 
jury. (No. 49.) 

m.- -This was a .-mall contused wound with loss of tissues below the left eye ; 
the superior maxilla was broken to pieces, so that the wound communicated into the 
antrum, and the haemorrhage was copious. The eye lids were much bruised and in 
the ocular conjunctiva 2 or 3 minute iron pieces wen to bi seen. On examining the 
antrum broken pieces of the bone and coagulated blood were found but no injuries to 
the other bony walls of the antrum. The wound fell to suppuration ; the eye lids 
were greatly swollen, the swelling, however, subsided in course of time. On exami- 
nation, the vision of the left eye was reduced to -^, with retinal hemorrhage. The 
left cheek and lips became anaesthetic. The wound was completely healed by Decem- 
ber 18th ; the eye-sight was not yet recovered, the anaesthesia of the left cheek and 
lips also still lingered. So the patient was dismissed from service on February 9th 
of the following year. Besides the wound mentioned above, the patient received a 
perforated wound in the upper part of the left arm, and two contused wounds in the 
upper part of the left forearm attended with fractures. (No. 103.) 

p. — This was a case of a contused wound 6 c m. long, on the left side of the 
forehead. The wound reached to the bone and detached the pericranium, hut the 
bone was intact. The soft tissues around the wound were irregularly torn and swoll- 
en, and the skin below the eye of the same side presented a purplish discolouration. 



290 CONTUSED WOUND. 

A short time after the injury, epistaxis twice appeared. The patient's mind was clear 
at first, hut afterwards signs of cerebral irritability appeared, and he would bend or 
toss about his body and limbs, and at times fall into stupor with occasional delirium 
and incontinence of urine. After a couple of days, the wound suppurated and the 
cerebral symptoms persisted, the patient was unconscious ; his pupils were contract- 
ed, with sluggish reaction to the light. The temperature fluctuated somewhere about 
38° C; afterwards the pus burrowed beneath the occipito-frontalis, so a counter open- 
ing was made. Ten days after this, his mind became somewhat clearer though he 
still suffered from headache, and in 3 weeks after the injury, the brain symptoms had 
entirely gone, and -I months after, he returned to duty. This was probably a case of 
fracture of the base of cranium. (No. 52. 1 

0. — This was a case of several wounds caused by many fragments of a shell : — A 
contused wound c. m. long and 1 c. m. wide and as deep as the pericranium in the 
vertex ; a contused wound 3 cm. in length and 1 cm. in width, running laterally 
along the right side of the upper lip ; a contused wound 12 c. m. long and 7cm. 
wide, stretching from the inner side to the posterior surface of the left thigh ; a con- 
tused wound which destroyed all the digits of the 1st, 2nd and 3rd toes of the left foot 
After a few days, the fore part of the injured foot became gangrenous and Lisfranc's 
disarticulation was performed, and in 5 months all the wounds were healed, yet on 
account of the loss of a part of the foot, he was discharged from service. (No. 304.) 

Other contused wounds besides those stated above, showed more or less difference 
in size, but most of them were only cases of contusion of the soft parts without any 
complications worthy of record ; and a few which were attended with fractures were no 
more than wounds as of fingers, which healed in due course of time and presented no 
interesting phases. They are, accordingly, omitted here. 

Contused wounds caused by shell -fragments totalized 97 as has 
been mentioned; it' this lie compared t<> 289, the total number of 
various wounds from the same cause, it will hear a ratio of 33.56 per 
(•int. a sum which stands highest among all kinds of the wounds pro- 
duced hy shell-fragments. However, as will be shown later, compared 
with iron-pieces or wooden splinters, shell-fragments hear comparative- 
ly a low ratio, in producing wounds '•!' this kind. This is because 



CONTUSED WOUND. 291 

shell-fragments having, as a rule, it stronger force than the others, are 
more prone to produce other kinds of wounds; that is, penetrating or 
perforated wounds with the smaller fragments, and mutilating 
wounds with the larger ones. The size and severity of contused 
wounds from shell-fragments do not only greatly differ according to the 
size and force of the fragments, but also according to the character of 
the surfaces with which they sti'ike the skin, that is, whether they have 
a plain surface or an edged. For example, there are some cases in 
which the skin was opened, soft tissues smashed and a deep seated bone 
as the femur crushed to pieces (as with cases a & e ; and sonic cases in 
which though the injury was confined to the soft tissues, yet it was 
extensive in area as is remarkably seen in case /,', which was perhaps 
caused by a large shell-fragment flying nearly parallel with tin' long 
axis of the injured limb; just in the same way as a small shell-frag- 
ment which produces a grooved wound. And there are cases in which 
the injury was so small and shallow that the skin and subcutaneous 
tissues only were rent. So we see striking differences in tin- severity 
of the contused wounds. However, in every case, the wound had an 
irregular surface, with severelv contused margins so that the vital 
function of the tissues was lost. Again, of those cases in which a part 
lacking soft tissues was hit by a small shell fragment, the contusion 
was mostly very slight, in these cases, a portion of shell -fragment 
may, in spite of having penetrated into the tissues, fall out again, ow- 
ing to the resistance of the hard bone. Accordingly, there may be 
some cases which should properly lie enumerated among blind wounds, 
but the distinction is difficult as the fragment was not retained in the 
wound. The contusion of the head is naturally very serious; in cases 
li & k, the skull was extensively broken involving the brain substance, 
so that the men died on the spot. Case n was a case of contused 
wound 6 cm. long, on the forehead; it reached the bone though no 



292 ' 02TTUSED WOUND. 

lesion was then recognized in ir. but by subsequent symptoms it was 
plain that the orbital plate of the frontal bone and ethmoid wen- frac- 
tured. The case fortunately recovered. With bullet wounds, it is a 
matter of so rare occurrence, that an indirect fracture like the above is 
still a matter of doubt as to its possibility, while ir is a matter of 
course with gun shot wounds. For. if a shell-fragment which is 
heavy but not high in velocity, strikes the head with it.- dull round 
surface, the skull may escape fracture owing to the wide ai-ea of the 
bonv surface, but. the pressure diverging in every direction, the weak- 
est part is liable to be broken. Case c was attended with a fracture in 
the temporal region but without any injury in the brain substance, nor 
any remarkable haemorrhage within the cranium. Unconsciousness 
present at the beginning must have been the result of concussion, and 
rlie pain and struggling agony which occurred after the recovery of 
consciousness were the result of r he burns received all over the body. 
It is a well. recognized fact that sufferers from extensive burns show the 
same symptoms, sometimes accompanied by toaumatic delirium. Case 
f was a ease of contused wound .'! cm. in length on the left parietal 
region breaking the outer plate of the parietal bone. It was uncertain 
whether the inner plate was broken or not. yet as far as examination 
proved, the bone lesion was only in the outer plate, as no brain sym- 
tom was present, and even, granting that the inner plate was injured, 
ir was not broken To pieces as the outer plate. The inner plate as a 
rule is liable to be broken more widely than the outer, and accordingly 
it is not infrequently found that the former is injured when the latter 
is intact. The reverse is a matter scarcely recognized in military 
surgery, and its very possibility is still questioned. However, as far as 
the evidence of the present uaval battles _■ s, there were not a few 
cases in which bones, besides the skull, were injured only on the su- 
perficial layer or the outer wall, so that when hit by keen edges of a 



CONTUSED WOUND. 293 

weak shell-fragment, the bone like the skull sustained injury only on 
its outer plate. Case i was a small contused wound on the upper part 
of the right temporal region, in which though no bony lesion was 
recognized yet anaesthesia and paresis of the left index-finger appeared. 
Whether this was consecment upon the pressure of the centre of the 
finger, located behind the fissure of Rolando, by a .small extravasation 
of blood arising from fissures made in the inner plate of the bone, or 
upon the injury of the brain by the piece of broken inner plate, or 
upon a small contusion on the superficial layer of the brain without 
any lesion to the hone or membrane, is not ascertained. For, it could 
not be known whether tin-re were symptoms of cerebral irritability or 
compression at the time of injury, as all the surgeons on board the ship 
were killed, and the clinical records are so brief that no inference 
can now be drawn from them. But considered from the fact that the 
paralysis and anaesthesia were confined to the index finger, the injury 
within the skull must have been very slight. 

(2) Contused wounds caused by iron-fragments totalized 25 
cases occurring in 11 persons. They differed greatly in their severity. 
but all except those stated below, were healed in due course without any 
interruption, and presented no interesting features worthy of record, 

l>t instance : — This is a ease of a contused wound 4 cm. long and 2 cm. wide, 
running forward from the right angle of the lowet jaw along its lower border. It 
was caused by one of the scattered fragments of the funnel, the lower part of which 
was perforated by a hostile shell. The margins of the wound were extremely ragged 
and the outer plate of the jaw was broken to pieces, some of which were found free, 
hut the inner plate was not involved, nor the facial artery injured. The wound fell 
to suppuration, but toak a favorable course, and was healed in two months. (No. 104.) 

2nd instance : — From the same can-.- a- the above, the front part of the left knee 
joint was struck ; the skin was widely torn, and the patella and lower end of the 
femur were crushed, hemorrhage was not copious : tin- popliteal artery seemed to be 



•294 CONTUSED WOUXD. 

intact. Besides this, the man sustained a blind wound in the back. The patient 
was clear and firm in mind without any sign of cerebral concussion. On the next day. 
the resection of the left kuee joint was performed and he was on the :21st. admitted 
to the Sasebo Naval Hospital. At the time of admission the part below the knee 
joint was cold and numb, and the foot had already become gangrenous. Therefore 
the amputation at the lower part of the thigh was performed, and the wound was 
completely healed in January of the following year. (No. 270. 

3rd instance : — This was a contused wound 2 cm. long on the outer side of the 
lower end of the left tipper arm from an iron fragment. The wound reached the bone 
giving a little depression with superficial fissures in it. No foreign body was lodged 
within. After 3 or 4 days, the margins of the wound sloughed off and the wound was 
soon healed. iXo. 206.) 

4th instance: — A contused wound on the inner side of the upper part of the 
right leg. The margins of the wound were torn and gaping ; at the bottom the 
periosteum of the tibia was detached, and beneath it several fissures of some 2 cm. 
long were produced. After a time, loose pieces of the bone were extracted from the 
wound of the leg, after which the wound made due progress and was healed in 2 
months. (No. 280.) 

5th instance : — The forehead was struck by a fragment of a guu-shield broken 
by a hostile shell, and the posterior half of the bone was smashed, the brain substance 
being at the same time destroyed. This case was accompanied with the mutilation 
of the left forearm. The injured man was killed on the spot. No. 16. 

0th instance : — From the same cause as the abort . • head was smashed 

resulting in instant death. (No. 50.) 

7th instance : — A small contused wound. just above the internal condyle of the 
right humerus. The wound measured about 1.5 cm. in depth : the margins were 
peeled off the fascia for 3 cm. in the form of a bag ; the bone and the ulnar nerve 
were found safe, but afterwards the parts supplied by tlie nerve, that is ; the palmar 
and ulnar sides of tlie right ring finger, the whole of the little finger, and the inner 
border of the palm were affected with loss of motion and sensation. The wound 
healed in 5 weeks, but the numbness and paralysis of I rs lingered 3 weeks 

This was probably due to the contusion of the ulnar nerve. N". 'J00.) 

Contused wounds caused by iron-pieces were 25 which, propor- 



contused worm 295 

tioned to the 60 cases of various wounds produced by the same cause, 
would bear a ratio of 41.67 per cent. This kind of wound therefore 
stands highest among the various wounds by iron-pieces. Compared 
with 33.5(3 per cent which is the ratio of contused wounds owing to 
shell-fragments, this wound seems to have a comparatively larger rate. 
This is perhaps due to the fact, that though many of the iron-pieces are 
big and heavy, and irregular in shape, yet the velocity is less than that 
of shell fragments and more tit to produce contused wounds or con- 
tusions. The contusion of the tissues around the wounds are the same 
with those caused by shell-fragments in character; for instance, in the 
1st instance above mentioned, though the outer plate of the lower jaw 
was broken, vet the inner plate was sound, in the 3rd instance, a 
small shallow circumscribed depression was produced on the outer side 
of the lower end of the humerus. In the 4th instance, 2 or 3 fissures 
some 2 cm. in length were produced on the inner side of the upper 
part of the right tibia. These limited shallow lesions of hones were 
perhaps due to the fact, that the bony surface was directly hit by an 
edge of an iron-fragment. Had a part abounding in soft tissues been 
hit. a blind wound would surely have been produced. The said iron- 
piece being small and weak in force could not perhaps inflict more 
than a slight injury to the hone. It can easily he seen that a missile 
like bullet which is so great in velocity and has so obtuse a surface, 
would often inflict injuries more severe than in the present case; but a 
projectile like an iron-piece which has sharp edges but a weak striking 
force, is more fit to produce a hone injury of this kind. The 2nd in- 
stance is the case (.fa great contused wound in the front part of the 
knee-joint, in which the patella and the lower end of the femur were 
smashed, and an amputation was performed. Haemorrhage was slighl 
at the time of the injury, and the popliteal artery was found safe, vet 
considered from the gangrene which set in soon alter, there must pro- 



296 CONTUSED WOUND. 

bably have been an injury of that artery. With regard to this case, 
further remarks will be made later on. The 7th instance was the case 
of a contused wound just above the internal condyle of the right 
humerus. Though apparently there was no injury of the ulnar nerve, 
yet seeing that numbness and paralysis ensued in the regions distributed 
with the nerve, there must have been contusion of the nerve. The 
5th and 6th instances are the cases of contused wounds of the head, in 
which the hone and brain were crushed, causing instant death. No 
wonder such fatal wounds should he inflicted by blows from large 
iron-pieces. 

(o) Twenty three cases ot contused wounds caused by wooden 
splinters occurred in ill persons, most of them were slight ones, and 
the only cases of any interest are as follows : — 

The 1st example was a small contused wound in the left parietal region caused by 
a wooden splinter. The scalp was turn, but the wound was shallow and did not pierce 
the occipito-frontalis, and there was no sign of bone lesion. However, alter a while, 
paralysis in the right side of the face appeared, so that the eye-lids could not properly 
be closed, and the tongue inclined toward the right side, and the speech was also im- 
paired, attended with a slight paralysis of the limbs of the same side. Though the 
wound of the head healed before long, it was 2 months before tic paralysis was cured 1 
(No. 38.) 

The 2 example was the S shaped contused wound, '.I c. m. long, running obliquely 
upwards from the upper part of the left superciliary ridge of tin' forehead. It reached 
to the bone which was broken. Besides, on the right side of the face were burns, and 
the sight of the left eye was greatly impaired. Hut no symptoms of brain injury ex- 
isted. On ophthalmoscopic examination, hemorrhage of the retina was recognized. 
\it.r 10 days the wounds healed, but the sight was not restored, and attended with 
diminution of the field vision. In spile of every means of treatment recovery of the 

sight was hopeless, and ai rdingly the patieut was discharged from service for life. 

(No. IT. 



CONTUSED WOUND. 297 

The 3rd example was a contused wound inflicted by a flying wooden splinter. 
The wound was 4.5 c. m. in length and 1 c. m. in width extending from the left 
frontal eminence to the upper eye-lid passing between the eye-brows, and penetrating 
to the bone. The margins were torn attended with slight haemorrhage. Both the 
upper and lower eye-lids were greatly swollen witli an extravasation of blood, and 
beneath the ocular conjunctiva and in the anterior chamber there was hemorrhage. 
The cornea became opaque, and the sight was entirely lost. The wounds gradually 
healed, but the swelling of the eye-lids still remained so that the eye could not be 
opened. The ocular conjunctiva became inflamed and swelled, so as to completely 
cover the cornea which was opaque ; the conjunctiva of the right eye was also conge- 
sted. In a month after the injury, the wound was completely healed, but the opacity 
of the left cornea remained as ever, and the sight was not restored ; the inflammation 
of the conjunctiva declined, but pain in the eye was present. After a time, the 
inflammation gradually abated, but the left eye withered by degrees, and the right eye 
was inclined to become inflamed. The left eye was enucleated and an artificial eye 
put in. The left eye ball was atrophied and all the tissues shriveled. The right eye 
became restored to its normal state, ami the patient left the hospital 4 months after 
the injury. (No. Hilt.) 



There were 23 cases of contused wounds caused by wooden 
splinters which if proportioned to 58 cases, the total number of various 
wounds occasioned by the same cause, will give a ratio of 39.66 per 
cent, and so arc the most numerous among the various wounds inflict- 
ed by splinters. Thus we can see that this ratio is larger, than that of 
the contused wounds caused by shell-fragments, and about the same as 
that of the contused wounds produced by iron-pieces. This is because 
wooden splinters being weaker in force than the iron-pieces, most of 
the splinters will not do more than produce either contused wounds or 
contusions. Therefore, if the united number of contusions and con- 
tused wounds caused by wooden splinters, he compared to the total 
number of various wounds produced by the same, the former will bear 
a ratio of 68.97 percent, which is much larger than the 40.14 per cent, 



298 CONTUSED WoUXD. 

the equivalent ratio of wounds caused by shell-fragments, and than 
50.00 per cent which is that of iron-pieces. The reasons why wooden 
splinters inflict contusions in some cases, and contused wounds in 
others depend on the following conditions : — firstly, difference of force 
according to size, even among splinters originally weak in power; 
secondly, existence of ragged edges; thirdly, the locality of the part 
struck, for, if the part struck is wanting in soft subcutaneous tissues 
and so docs not allow the skin to yield, it is liable to lie rent open and 
sustain a contused wound, while the part which abounds in soft tissues 
yielding to the pressure will naturally escape rupture. Of 23 wounds 
as stated just now, 17 were in localities wanting subcutaneous tissues, 
such as the head, face, fingers, front of the leg and dorsum of the foot. 
and of the 17 wounds. 12 were on the head and face, none of them, 
however, was fatal as would be the case with a shell-fragment or an 
iron-piece, this proves the weak force of the wooden splinters. The 
1st example of contused wounds mused by wooden splinters was in 
the lower part of the left parietal region. The wound was shallow, so 
that the aponeurosis was not pierced, but paralysis of the right side of 
the face, tongue, and the upper and lower limbs supervened, and 
amnesia was present; tliis was certainly attributable to the injury of 
the cortical substance of the brain around the fissure of Rolando; 
hut what was the nature of it could not he ascertained. In this case 
the contused wound of the scalp was shallow, and did not pierce the 
aponeurosis ami hone lesion was not found even if it existed, hut such 
a wound, if caused by a somewhat larger and heavier splinter, mighl 
have broken the parietal hone beneath, without the aponeurosis being 
pierced, and such cracks may escape observation from the outside. 
Besides, ii may be presumed that one of the anterior branches of the 
middle meningeal artery, running in the grooves of the inner surface ol 
the parietal hone was ruptured at the same time, and thus an extra- 



CONTUSED WOUND. 299 

vasation of blood between the b me and dura mater in the neighbour- 
hood of the fissure of Rolando caused the hemiplegia of the opposite 
side. Considered from the situation of the scalp wound, there is 
reason enough to account for the above .statement. However, the fact 
that in the course of two months, the symptoms gradually abated and 
at length disappeared does not agree with the usual course of the 
haemorrhage of the middle meningeal artery. Such haemorrhage is, as 
a rule, a serious case, in which symptoms of cerebral compression 
gradually arising, mostly results in death. At best, hemiplegia of the 
opposite side will persist. Therefore, if the case in question was due 
to the haemorrhage of the artery, we can only attribute it to a slight 
bleeding from a small branch of the said blood vessel. However, as 
with the case i of the contused wound caused by .shell fragments, 
owing to the death of all the surgeons on hoard, the clinical record of 
this case is imperfect, and it is not known whether there existed 
symptoms of concussion, compression, and spasm on the paralyzed side; 
so, these are the possible causes : — pressure by haemorrhage of the 
artery; contusion, of the brain; injury of the cerebral substance by a 
piece of bone broken off on the inner plate of the skull, or septic 
inflammation in the skull at the part struck, vet. judging from the 
symptoms and course as fur as were known, it is most likely that a 
depressed fracture or a septic inflammation was not the cause. 

(4) Cases of contused wounds, sustained by persons who hap- 
pened to be near where .shells exploded in which the cause might be 
attributable to various kinds of fragments, that is, those of wooden and 
iron materials of the ship, as well as of shells, are as follows : — 

1st example. — A man acting as carrier of the wounded had brought a patient to 
the surgery in the ward-room on the lower deck, when a 30.5 cm. shell exploded 
agaiust the inizzen-mast in the room and killed the carrier by inflicting contused and 



300 CONTUSED WOUND. 

lacerated wounds on the head, face, trunk and limbs, and also burns all over the body. 
(No. 29.) 

2nd example. — A man who was struck by shell fragments as well as splinters 
sustained compound fracture of the face and base of cranium, and a large contused 
lacerated wound attended with fractures of the lower and upper limbs. The man was 
killed on the spot. (No. 54. ) 

3rd example. — Was a large contused lacerated wound in the middle of the right 
thigh, by the same cause as above. The soft tissues were very much severed, and the 
femur was smashed to pieces, besides, serious contused lacerated wounds were inflicted 
on the right arm and right side of the chest. The shock killed him instantly. 

•1th example. — Was a large contused lacerated wound accompanied with fracture 
at the middle of the right femur by the same cause as the last, and a perforated 
wound of the abdomen. The injured man died on the spot. (No. 174.) 

5th example. — From the same cause as the last, a contused lacerated wound 
5 cm. long reaching the pericranium in the vertex, a small sized contused wound as 
deep as the above, below the left mastoid process of the occiput, a large contused 
lacerated wound which smashed the tibia and fibula at the upper third of the right leg, 
several wounds with loss of substance at the lower third of the right thigh, and a deep 
contused wound with loss of substance just above the left patella were received ; and 
in addition to these, there was a contusion on the left temporal legion, and burns all 
over the face. In a few days the injured man began to show signs of traumatic 
delirium, his mind was confused and he was restless, his temperature rose to 39° C, 
the right leg became gangrenous from stoppage of circulation, so amputation was 
performed at the lower part of the thigh. The delirium continued as before, and the 
patient died on the following day, that is, the fourth day after the injury. (No. "288.) 

These arc the cases of which the real causes could not lie ascer- 
tained as they occurred in the surgery of the Hiyei, where a 30.5 cm. 
shell exploded, breaking the iron-mast ami smashing the tahles ami 
various surgical instruments, ami drove the various fragments on all 

sides, so (hat it was practically impossible to ascertain which of these 
caused each of the aliove stated cases. The number of the wounds ot 

this category i-- 20 occurring in . r > persons, id which 1 persons were 



I i ttTUSED WOU-XD. 301 

kilk-d on the spot and 1 person died on the fourth day of injury. 
Each of these persons sustained many contused lacerated wounds, of 
which the serious ones seem to have been caused by shell fragments, 
hut as there were other iron-pieces thai were large and heavy, clear 
discrimination can Dot of course be made. Those who were injured 
by being near where a shell explosion occurred, were not only struek 
by shell fragments, or iron and wooden splinters, but were liable to 
sustain other wounds from the expansive power of the gas, or from 
the tlaine. The latter kinds of wounds are often dwelt on under a 
special head. " The Explosive wounds," and therefore we shall treat 
of it under the subject of the crushed and mutilated wounds produced 
by the same cause. 

(5) There were 1 2 contused wound.- in which the cause of the 
wound was ma ascertained, whether by iron fragments or wooden 

splinters. 

1st example:— A cook was struck by iron and wo u j ieces which were produced 
by the destruction of the lower deck by a hostile shell, and sustained a contused wonud 
8 c. in. long and 1 c. in. wide on the upper lip, and a contused wound 10 c. m. in 
length and 1 c. m. in width extending from the right ear to the rig] the neck, 

and small contused wounds, one each on the right eye-brow and cheek, and 3 small 
contused wounds on the left index finger, and a contused wound 2 e. in. square on the 
outer side of the middle of the right thigh, and another, 4 c. in. square, behind the 
right elbow joint. In each of them, the margins were irregularly lacerated, present- 
ing a purple colour, threatening suppuration, all the wounds were cared within a 
fortnight. (No. 98.) 

2nd example : — Was a contused wound on the outer side in the middle of the 
right arm by iron and wooden pieces, which suppurated, and at last were healed after 
(i weeks. This man was the same as the 3rd example of contusions caused by splint- 
er-.. 

((1) Instance- of contused wounds caused by a fall produced by 
shock are as follows : 



302 CONTUSED WOUND. 

Contused wounds caused by the fall produced by shock of a shell striking an iron 
wall near by, were inflicted in the left hypochondriac region and in the left calf. The 
shock made him unconscious, but when he came to himself, the wounds were dressed 
and he resumed his duty. After a little while another shell exploded on the lower deck 
in the fore part, setting a large amount of the gun powder on fire, and he was again 
thrown down, and struck by a shell-fragment on the back of the parietal region, and 
he sustained a small contused wound. The latter was cured in a few days, while 
those on the hypochondrinm and the calf suppurated, and were at last healed after 
seven weeks. (No. 138.) 

Besides this, their were cases of small contused wounds on the lumbar and iliac 
regions and in the front of the right ear. 

The number of the contused wounds caused by the fall conse- 
quent tn shock is .">. and the wounds produced by this cause are only 
contused wounds and contusions. Oflhe.se. the latter are by far the 
more numerous as already stated, amounting to 73.68 per cent of the 
united number, and the former were only, 26.32 per cent. It is 
natural that contusions should occupy so large a space, for the con- 
tused wound is produced only, when one happens to fall on an object 
having acute edges. 

(7) Contused wounds owing to compression and collision wen- 
two : line was a ease of crushed finger caused by tumbling down from 
the shock of the firing, the other a ease of contused wound of the 
fingers from colliding with the keen edges of a hole made by a shell in 
the ship's side. As has been stated, the entire number of contused 
wounds were INI. which proportioned to 629, the total number of 
various kinds of wounds, hear a ratio of 29.25 per cent, thus standing 
the highest among all kinds of injuries. And if we classify these 
L84, their causes will he as follows:— '.'7 wounds from shell frag- 
ments : 25 from metal pieces : 23 from wooden splinters : 20 from 

unknown material whether shell fragments, iron or w leu pieces ; ."> 

from being tin-own down by shock: L2 either from iron pieces or 



CONTUSED WOUND. 303 

wooden splinters; one from compression and one from collision. Tt is 
natural that contused wounds should reach the largest total in a naval 
combat. As the contused wound is a contusion attended with the des- 
truction of the skin, the object which produces it must have two re- 
quisites : Firstly, it must have a force, that is, velocity or weight, large 
enough to ruin the skin and other tissues. Xow. in the naval combat, 
both shell-fragments and iron or wooden pieces which are the chief 
missiles, have coarse surfaces and at the same time are heavy; and 
besides, as they very seldom strike parsons at a distance, their 
velocity even though originally not so great, has more than suffi- 
cient power, when combined with their weight to produce this kind 
of wounds. Secondly, the object must be a body which though it 
ruins the skin and other tissues is not capable of penetrating. 
Now the shell-fragments to be seen in the naval combat, are not 
only mostly large in form, but are extremely irregular in shape 
having a coarse surface ; and therefore, they possess a sufficient force 
♦ o destroy the skin and tissues, but are quite unable to penetrate 
the tissues or perforate them. Moreover, as the shell -fragments and 
pieces of iron or wooden materials possess an irregular shape, some of 
them may have sharp edges together with a rough surface, and such may 
be small in form, and devoid of weight and velocity, so that they have 
not sufficient force to penetrate into the tissues after striking the skin ; 
yet by breaking open the skin they do often produce contused wounds. 
This is especially the case when they strike parts wanting subcutaneous 
soft tissues, like the head, or the front of the leg. And sometimes 
there occur cases of contused wounds from other causes ; for instance, 
colliding with various objects when thrown against them by the shock 
of an explosion, etc. Therefore, it is no wonder that the wounds of the 
kind under consideration should be most numerous. 



304 BLIND AND PENETRATING WOUNDS. 

4.-BLIND AND PENETRATING WOUNDS. 

(1) Blind and penetrating wounds caused by shell-fragments: — 
in this group there were 57 wounds, ^occurring in 41 persons, of 
which some of the interesting cases are as follows : 

1st example: — 7 persons were killed on the spot, owing to penetrating wounds 
of the head caused by the fragments of shell, and 1 person died within the day of 
injury from the same cause. (Xos. 45, 55, 5G, 57, 58, 61, 62. 63.) 

2nd example: — Penetrating wound in the left side of umbilicus. When admit- 
ted to the hospital, four days after the injury, the symptoms of diffuse peritonitis were 
marked : the abdomen was tympanitic with nausea and vomiting, ejecting a blackish 
fluid, and abdominal pain was also intense, the general strength of the patient was 
failing, and at last he succumbed. (No. 163.) 

3rd example: — A shell fragment penetrated into the abdominal cavity, crushing 
the anterior superior spine of the right ilium, and the intestine protruded from the 
wound. The injured man was killed on the spot. (Xo. 166.) 

4th example : — A penetrating wound in the umbilical region with protrusion of 
small intestine. The man also sustained a small blind wound in the left thigh. He 
was killed on the spot. (Xo. 164.) 

5th example: — A case of penetrating wound below the umbilicus with protrusion 
of the intestine ; also, on the right upper arm as well as the left thigh and leg. exten- 
sive contused lacerated wounds with fractures of the bones. The injured man was 
killed on the spot from shock. (Xo. 165.) 

6th example : — A case of blind wound in the middle third of the right leg. 
After admission to the hospital, a shell fragment 2.7 cm. in length, 1.7 cm. in width, 
and 1.5 cm. in thickness was extracted, and the wound was healed in 5 weeks. 
(No. 2S0.) 

7th example : — A case, of blind wound in the middle of the hit upper arm. It 
reached the hone, but without injuring it. There was als >. a blind wound in the left 
forearm which crushed the upper part of the ulna with lodgement of shell fragmi ill 
in the bottom of the wound ; the brachial artery was ruptured at its bifurcation, but 
hemorrhage was not copious. Pulsations of the radial and ulnar arteries were entire- 
ly lost. When admitted to the Sn ebo Naval Hospital 1 days after the iujury, the 



BLIND AND PENETRATING WOUNDS. 305 

left forearm was already mortified. Accordingly, the upper arm was amputated at 
its middle part ; and the stump was healed iu 12 weeks. The injured man was then 
invalided for life. (No. 224.) 

8th example : — In the upper part of the right thigh, a blind wound was inflicted, 
together with a perforating wound of the right shoulder attended by the fracture of 
the scapula. The blind wound of the right thigh was situated just below the Pou- 
part's ligament ; the wound canal, taking an inward and downward direction, mea- 
sured C cm. in depth ; and the inlet was a mere fissure hardly admitting the tip of 
the thumb ; at the bottom, a shell fragment was found and extracted. The wound 
was healed iu 6 weeks. (No. 193.) 

9th example : — In front of the neck, there was a blind wound, by which the 
trachea and the (esophagus were both rent open, and the right common carotid artery 
being also injured, the injured man succumbed ou the spot. (No. 127.) 

10th example: — Just below the Poupart's ligament, a transverse lacerated wound 
measuring 4.5 cm. in length and 10 cm. in depth ; at the bottom, a shell fragment 
was found, which being taken out measured 5 cm. in length, 2.5 cm. in width in its 
widest part, and 1.5 cm. in thickness, a piece of cloth was firmly sticking to a part of 
the surface of the fragment. The wound was suppurated, but finally healed in more 
than 4 months. (No. 254.) 

11 th example: — Along the 10th rib in the dorsal aspect of the left side of the chest, 
a penetrating wound 15 cm. long and 5 cm. wide, running obliquely along the rib and 
iu the lower margin of the wound. The rib was broken and the lung injured, so that 
an emphysema resulted in the tissues around the wound. The man also sustained 
perforated wounds of both arms, and several lacerated wounds over the body and limbs. 
After a time, the subcutaneous emphysema in the back had gradually extended to the 
abdomen and scrotum, it however disappeared after some ten days, without causing 
any marked interference, when the wound orifice was closed by the development of 
healthy granulation. The wound was completely healed in 8 weeks. (No. 209.) 

12th example : — At the juncture of the middle and the lower third of the right 
thigh, a blind wound. The femur was obliquely fractured and a shell fragment was 
lodged under the skin of the opposite side. Accordingly the skin was cut open, and 
an irregular cuboid shell fragment 2.3 cm. long, 1.8 cm. wide and 1.5 cm. thick 
was extracted. The wound suppurated, and three pieces of the broken bone were 



306 BLIND AXD PENETR ATI N<; WOUNDS. 

tak. 11 cut. After that, the wound progressed favourably and healed in 7 weeks. 
(No. 259.) 

loth example : — Owing to the explosion of a hostile shell in the turret, there were 
inflicted two lacerated wounds in the lower part of the left forearm ; the radius was brok- 
en, and a foreign body was lodged in the bottom of the wound : The orifice of the 
wound was therefore widened and a shell fragment 1.5 cm. in diameter was extracted. 
There were also burns in the right temporal region with rupture of the right memb- 
rana tympanum. Afterwards, several pieces of the broken bone came out of the 
wound of the forearm; suppuration continued a long time and the complete healing 
of the wound required six months. | No. 225. i 

14th example : — A case of blind wound on the back of the left thigh, the wound 
canal measured 10 cm.; at the bottom, was lodged an irregular oblong shell frag- 
ment 8 cm. long, 2 cm. wide and 1 cm. thick, which was extracted after admission 
t i tiie hospital. Afterwards, the canal suppurated, assuming a fistulous condition, 
and constantly discharged pus. The sinus walls were frequently scraped ; the heal- 
ing process however, was so slow that it required altogether eleven months to heal. 
(No. 255.) 

loth example : — A case of blind wound in the upper part of the right upper 
arm ; and another one in the lower part of the right forearm. The former wound 
reached to the surgical neck of the humerus, where a shell fragment was found wedg- 
ed into the bone substance. The wound in the forearm fractured the radius, but 
the presence of a foreign body was uncertain. However, after admission to the hos- 
pital, the wound was widened and an irregular shell fragment 2 cm. long, 1.5 cm. 
wide, and m.m. thick was found and extracted. Both wounds suppurated, and that 
of the forearm was healed in the course of 7 weeks and that of the upper arm in •" 
months. (No. 208.) 

16th example : — A ease of blind wound on the inner side of the right ankli , ;i 
sh( 11 fragment wi dgi 1 into the tissues which the man extracted himself as a part of 
the fragment was exposed. The tibia was not broken. The wound was healed in 

five Week.-. (No 802. 

17th example :• — A case of penetrating wound of the right knee joint, the tendon 
of quadriceps extensor and patella were broken, and fragments of shell and bone re- 
tained in the joiut cavity, but both the femur and tibia were intact. The injured 



BLIND AND PENETRATING WOUNDS. 307 

man also sustained several lacerated wounds on the head, face aud upper limbs. Th • 
wound of the knee suppurated, aud healed in 5 months, leaving ankylosis of the joint. 
He was permanently discharged from service. (No. 271.) 

18th example : — Owing to the explosion of a shell, one of the small fragments 
penetrated into the left eye ball at the inner can thus ; at the same time the burns on 
the face were sustained. A small blind wound on the inner surface of the upper 
third of the left leg was also inflicted, which measured 7 cm. in depth and a foreign 
body was present at the bottom, which was extracted by making a counter opening. 
The body proved to be a metal piece, the size of tip of the thumb. The left ocular 
conjunctiva was inflamed and the anterior chamber filled with a dark reddish fluid, 
the pupilary region presented a yellowish hue and the vision was completely lost. 
The conjunctiva of the right eye was congested and the sight was somewhat impaired. 
The wound of the leg was healed in 3 months. Nevertheless, the sight of the left eye 
was not restored at all, and the irritative congestion of the conjunctiva in the same 
eye still persistently remained, with gradual shrinking of the eye ball. The sight of 
the right eye was restored a little, but whenever the patient gazed at an object, 
muses volitantes were soon complained of. As the left eye presented no hope of re- 
covery, it was enucleated and an artificial eye was put on. A small shell fragment 
weighing 0.95 gramme was found lodged between the choroid and the serelotic at the 
back part of the eye-ball, The injured man was discharged from service for.Jife. 
(No. 111.) 

19th example : — A case of penetrating wound of the hack, below the left sca- 
pula, breaking the ribs. Dyspucea and great pain in the left side of the chest was 
complained of, in the movement of the body and respirations. When pressed, the 
margins of the wound gave a sensation as if snow were compressed, owing to subcu- 
taneous emphysema. From the wound, at each respiratory movement, blood mixed 
with air bubbles came out. In the night, precordial uneasiness, dyspnoea and pain 
in the chest were so severe, that the patient could in it have a sound sleep. The tem- 
perature rose to 38° C; urine was drawn by catheter. At the time of admission 
to the hospital on the fourth day after injury, coughing was incessant and a sputum 
stained with blood was expectorated. There was intense pain m the chest and the 
subcutaneous emphysema extended from the left scapular region to the axilla. On 
percussion, a slight duluess was revealed in the lower part of the left side of the chest. 
The cough and emphysema gradually subsided ; the bloody expectorations disappear- 



308 BLIND AND PENETRATING WOUNDS 

ed, the pain in the chest also abated by degrees, and the patient entirely recovered 
in 2 months. (No. 144.) 

20th example : — A case of blind wounds in the lower third of the right thigh 
and in the dorsum of the right foot. In the former wound, a fragment of shell was 
found and extracted ; the latter wound crushed 1st and 2nd metatarsal bones, which 
were excised, three small shell fragments being found at the bottom. The former 
wound healed in 3 months, the latter, in 7 weeks. The patient was discharged from 
service as his walking power was impaired. (No. 305.) 

21st example: — A gaping wound extending from the middle of the forehead to 
the bridge of the nose : and thus the nasal spine of the frontal bone, nasal bones, the 
nasal process of the superior maxillary bone, and a part of tin' perpendicular plate of 
the ethmoid were smashed. The wound presented a cavity, in which were lodged 
pieces of the bones and the shell fragment. Tin; right orbit was filled with extrava- 
sated blood and the eye-lids were strikingly swollen that they presented a dark pur- 
ple colour and one eye could not be opened. At the lower part of the right 
orbit, and on the right cheek, blind wounds were found, the latter containing a shell 
fragment as large as the tip of the thumb. Further, at the inner side of the right 
ankle was found a blind wound. When examined at the hospital, the right half of 
the face was greatly swollen and the eye of the same side could not be opened, the 
left eye was slightly swollen, and the conjunctiva a little congested. At the bottom 
of the wound in the right cheek, there was present a foreign body, which was extract- 
ed by enlarging the inlet and proved to be a small shell fragment. On examination, 
the right pupil was found dilated, and the sight greatly impaired, and in tin' fundus, 
detachment of the retina was recognized. Besides, anaesthesia in the right side of 
the forehead, temple and cheek was present. Also, a small shell fragment was ex- 
tracted from the wound of the right ankle. All the wounds were gradually healing 
and the sight of the light eye was restored in some degree, but external strabismus 
and double vision were left. The wound of the nose was healed by rhinoplasticy ; 
but the anaesthesia in the cheek and temple persisted as ever. The man was discharg- 
ed from sen ice. i No. 106. ) 

22nd example : — On the outer side of the lower part of the right upper arm was 

a lacerated wound 5 cm. long and I! e .in. wide. At its bott , the periosteum of the 

humerus was found detached, and the hone fissured in a star like shape, but no shell 
,i iiii' Se\ luI contused wounds were also inflicted on the liead, face. 



BLIXD AXD PENETRATING WOUNDS. 309 

and upper and lower limbs. These wounds were all healed in two months, hut 
ankylosis of the right elbow joint resulted, and the patient was discharged from 
service. (No. 207.) 

23rd example : — At the lower part of the right scapular region was sustained a 
small blind wound which was clogged with rent pieces of cloth. The cloth was 
extracted, the wound developed healthy granulation and the inlet healed in 2 weeks. 
A hard body being however felt at the part 3 cm. from the inlet, it was extracted 
by cutting upon the part, and proved to be a small shell fragment of a square form 
6 m.m. in diameter. (No. 141.) 

21th example : — A case of blind wounds on the inner side of the upper part of 
the light arm, on the posterior surface in the middle of the left forearm and on the 
ulnar side of the back of the left wrist. At the bottom of each wound were lodged 
shell fragments. Besides perforated and lacerated wounds were inflicted in various 
parts of the body and limbs. The wound of the upper arm was healed in due course 
of time, yet the loss of the use of the fingers consequent mi another wound placed 
him on the list of the invalided. (No. 229.) 

2.jth example : — At the middle of the posterior surface of the left leg a lacerated 
wound was sustained 3 cm. long and 1.2 cm. wide, running obliquely from upwards 
and outwards, to inwards and downwards. This afterwards suppurated, delaying 
the healing process. On minute examination, the wound canal had 6 cm. depth in 
a forward and downward direction, and a hard body was found at the bottom, which 
on removal, proved to be a cuboid shell fragment 2 cm. in diameter. This was 
wedged between the tibia and fibula, giving several fissures to the bones but without 
breaking them entirely. Progress of the wound was favorable and healed in 5 weeks. 
(No. 287.) 

26th example : — A case of blind wound on the left side of the chest, below the 
nipple. The wound reached to the rib ; but hemorrhage was slight, though the injured 
person fainted owing to shock. After admission to the hospital, a foreign body was 
found within the wound, and by enlarging the inlet a small shell fragment was re- 
moved. The periosteum of the rib was detached but the bone was sound. The in- 
cised part was sutured and a drainage tube inserted. Granulation was unhealthy 
with a slight discharge of pus, the healing process was very dull, so the granulation 
was scraped off, but the wound became fistulous and the recovery seemed uncertain. 



310 BLIN'D AXD PEXETRATIN't; YVOUXDS. 

On enquiry, the injured man Lad a syphilitic history ; accordingly anti-syphilitic. 
measures were taken and after a lapse of 7 months the wound was at last cured 
(No. 139.) 

27th example : — A case of penetrating wound of the forehead. The scalp wound 
was 2 cm. long and half as wide, and the bone was perforated with a round hole 
some 1 cm. in diameter, the presence of a foreign body could not be ascertained ; and 
no brain symptoms existed. Four days after the injury he was admitted to the 
hospital, when the wound was clean, granulations healthy without any signs of sup- 
puration, and no cerebral symptoms were present, except nocturnal sleeplessness. 
Tlie temperature rose to 38.° 5 C. but soon lowered to normal. In a week after ad- 
mission to the hospital, the patient complained of headache attended with a slight 
nausea and .sleeplessness at night. Ice-bags to the head and calomel purgative were 
used, and in a few days the headache subsided, the mind became clear, and the ap- 
petite increased. Ten days after, occasional tinnitus annum was complained of; the 
temperature was normal, but pulse slow counting o!> per minute. For some time, 
there was no marked change in the symptoms, however 15 days afterwards, the 
headache and tinnitus aurium became aggravated ; chilliness and fever set in, the 
temperature rose to 3S.° 3 C. From the wound in the forehead a slight discharge of 
pus appeared and the symptoms of brain compression gradually ensued. Accord- 
ingly trephining was performed and an abscess in the frontal region was found, how- 
ever, the locality of shell-fragment was not ascertained. The abscess was well washed 
with boracic lotion and a drainage tube inserted, after which the temperature abated 
somewhat and the subjective symptoms were relieved : but 3 days after, the tempera- 
ture again rose to 39° C, the pulse weak and quick counting 148, the respirations 
stertorous; the mind became dull, speech unintelligible, the eyes squinted, the pupils 
were unequal in size, and at length, the patient expired on the following day. (No. 59.) 

28th example : — A case of penetrating wound on the right side of the chest 
below the axilla. Also, a blind wound on the inner side of the lower third of the 
left leg, which reached beneath the skin on the opposite side, where a foreign body 
was lodged. By opening the skin, a shell fragment 3 cm. in vertical diameter, 1.0 
cm. in lateral diameter and 1.2 cm. in thickness was taken out. The patient was 
admitted to the hospital -1 days after the injury, when the wound on the chest emitted 
a yellow thin fluid, There was pain in the chest an 1 cough. The broken ends of 
the 10th rib were sharp and jagged, and were accordingly cut off. Furthei ixami- 



BLIXD AXD rEXETRiTIXG WOUNDS. 3H 

nation of the wound showed that the liver was perforat?d but the locality of the shell 
fragment was not known ; the temperature was normal. Discharge of a thin bilious 
fluid from the wound had not ceased, and the granulation was unhealthy. On ex- 
amination ten days after, a small flat piece of broken rib was found and extracted. 
Sloughed hepatic tissues were discharged from the wound. Subsequently an oral eleva- 
tion in the right side of the 1st and 2nd lumbar vertebrae was accidentally found, which 
gave a sense of hard body under the skm. By cutting the part open an irregular 
oblong shell-fragment l.S cm. long, 1.1 cm. wide, and 5 m. m. thick was obtained. 
This is perhaps a fragment which perforated the liver from the right side of the ch 
and lodged here. For some days discharge of a bilious fluid continued, occasionally 
mixed with debris of the liver, but it gradually diminished, and the granu- 
lation was improving, when suddenly the temperature rose to 39 3 C, on examining 
the wound, a small sequestrum and debris of the liver was found impacted in the 
wound, so that a thin pus was accumulating. These were accordingly removed, and 
the wound washed, when the temperature returned to normal, and from that time 
the course was favorable, and all the wounds were cured in more than one linn 
day-. (No. 161.) 

29th example : — A case of penetrating wound in the left side of the chest below 
the axilla. The wound took a downward and forwivr breaking the 10th rib, 

and entered the thoracic cavity. On the next day, sudden pain was complained of 
in the abdomen and the temperature rose to SS 3 C; on the following day the abdo- 
minal pain became much more severe attended with vomiting. When the patient was 
admitted to the hospital four days after the injury, the vomiting still existed, the ab- 
domen was tympanitic, the pain extreme, and the general strength greatly exhausted, 
exhibiting spmptoms of peritonitis. Also, the patient had a slight cough, spitting a 
small quantity of bloody sputum. The signs of peritonitis aggravated day after day : 
the abdomen was very tympanitic, the pain in the chest and the bloody sputum per- 
sist* '. and pus was discharged from the wound. On the 5th day after admission to 
the hospital, he succumbed to exhaustion. (No. 162 

30th example : — A case of penetrating wound on the right side of the chest, 
breaking the 7th and 8th ribs ; besides, the heel of the right foot was crushed, and 
burns on 1 . id, face, aud upper and lower extremities inflicted. On the next 
day. pneum ith >rax and sub^utaueous emphysema of the chest set in causing dyspuoe i 
and the patient at length died. (Xo. 321.) 



312 BLIN'D AVD PENETRATING WOUXDS. 

If flie 57 cases of blind ami penetrating wounds produced by 
shell-fragments lie proportioned to 289 eases, the total number of 
various wounds caused by the same missiles, the percentage will be 
1U.72. This ratio is smaller than 33.56 per cent of contused wounds, 
hut is larger than (>.57 per cent of contusions, 16.26 per cent of 
abrased wounds, 11.42 per cent of perforated wounds, or 9.34 per 
cent of mutilated wounds, etc. Thus this class of wound occupies the 
second place amongst the various wounds caused by shell fragments. 
This is for the reason thai the shell-fragments, though not increased 
in penetrating power by their irregular shape, vet bave as a rule, a 
stronger force than iron or wooden pieces, and accordingly not only 
penetrate the sofl tissues, but frequently destroy both hard and soft 
tissues, except when the fragments are either not very large or they 
have struck the skin with a flat surface. Compared with iron and 
wooden pieces, shell fragments are by far the more numerous causes of 
various wounds, so naturally every kind of wound is produced more 
by shell-fragments than by any other projectiles. This is especially 
the case with the blind and the penetrating wounds, for of these 
wounds 72.15 per cent were caused by shell-fragments, while other 
metallic pieces bore a ratio of 15.19 per cent, and wooden splinters 
6.33 per cent ; so it will he seen that in this class of wounds shell-frag- 
ments proved to he by far the greatest cause of wounds. 

The orifices of the blind and penetrating wounds in the skin have 
various shapes, jusl as there are sundry shapes and sizes of shell-frag- 
ments : hut considered in general, the wounds under this category 
usually have a lacerated form, attended with more or less loss of sub- 
stance, the margins being irregularly lacerated and the tissues around 
sustaining contusion. The lacerated appearance is caused as follows: — 
when the shell-fragment, which is not originally so great in velocity, 



BLIND AND PENETRATING WOUNDS. ;-{13 

strikes the skin, the latter with its elasticity yields under the pressure, 
and is rent open when it is stretched to the utmost, so that the part 
touched by the fragment is not punched off clean ; the remaining 
part assumes a lacerated form when the skin springs back to its norm- 
al state, accordingly as the tissues around the wound orifice sustain 
contusion owing to pressure, the size of the orifice is generally smaller 
than the size of the shell-fragment. In the clinical history, then' are 
many cases in which nothing is said about the relative size of the 
fragments and the wound orifice made by them, so that we can not 
give particulars in every case ; however, from what we can judge from 
the recorded case-, the orifices are, as a rule, smaller than the shell- 
fragments. This can be proved by examples Xos. 8, 10, 13, 14, IS, 
2<>. 21, 24, and 28. But when a part where the bone is superficially 
located is struck by a shell-fragment, the skin, being unable to yield 
sufficiently, is liable to be crushed : in such cases the wound orifice 
does not present a lacerated form, but according to the shape of the 
fragment, it may be an irregular square, an irregular round, or an 
irregular oblong. This is exemplified by Xos. 15, 21, 22, and 24. 
Again, even at a part rich in soft tissues, the tissues themselves afford 
more or less resistance, not as with the exit of a perforated wound, 
where there is no outward resistance ; hence the tissues are rent open 
after they have been stretched to the utmost, and the entrance orifices 
do not present simply a lacerated appearance, but arc always attended 
with more or less loss of substance. There are also some cases in 
which the length of the orifice is longer than the longest diameter of 
the shell-fragment which has produced it, as is exemplified by Xos. 6, 
11. 19, 23, and 25. etc. This is produced by the fragment striking 
the skin in a slanting direction, so that it first glances along the 
skin, and then enters deep into the tissues* This was especially the 



;;] 1 BLIND AND PEXETRATIXG WOUNDS. 

case with Xo. 11 in which a lacerated wound 15 cm. long and 5 cm. 
wide was produced, at its lower part breaking a portion of the 10th 
rib and injuring the lung. The size of the shell-fragment was not 
known, as its location was not ascertained : judging, however, from 
the slight damage done to the rib, it was plain that it was not actually 
so large as to produce a wound 15 cm. in length, and the dimension 
of the wound can only be accounted for by the oblique direction of 
the fragment. Seeing, however, that the wound was not only long, 
but had also a width of 5 cm., we feel justified in making the asser- 
tion that the fragment was not a small one. Moreover, from the pre- 
sence of a marked subcutaneous emphysema the lung was undoubted- 
ly injured, vet from the fact that no haemoptysis nor signs of the 
penetration of a fragment into the lung nor pain in the chest nor signs 
of pleuritis were present, we must infer that the fragment having 
partly penetrated into the tissues fell out of its own accord, and that 
the injury to the lung was caused by some pieces of the broken rib. 
As the shape of wound orifices differ, the margins are not necessarily 
irregularly lacerated, but sometimes are clean and sharp as if cut by a 
keen edge, as in cases 24 ami 25. This was due either to the frag- 
ments having keen edges all around, or to the high velocity of the 
fragments, or to the lack of subcutaneous soft tissues at the part struck, 
otherwise to the stretched state of the muscles and fascia at the time 
struck. 

The blind wounds caused by shell-fragments were not seldom at- 
tended with fractures. The 8 cases of the penetrating wounds ol the 
skull mentioned in the 1st example, and one in No. 27 will specially 
be treated later on. Other examples attended with fractures may be 
seen in Nos. 11. L2, 13, and 15 (wounds of the forearm) and in Nos. 
1'.'. 20, 28, and 29. Of these Nos. 11. 1'.'. 28, 29, and 30 were at- 



BLIN"D AND PENETRATING WOUNDS. ;^ 1 5 

tended with fractures of the ribs, Nos. 12 ami in , if the femur and 
Nos. 13 and 15 of the radius. These injuries of bones show that the 
shell-fragments were not very weak in force. < >n the other hand , 
there are cases in which though the fragment reached the hone, yet 
broke only a part of the hone, or gave no injury at all. thus indicating 
the weak force of the fragment. This is seen in Xos. 7. 15. 16, 17,21, 
22. and 25. Circumscribed fracture of a hone in the neighborhood of the 
part struck by the fragment is of very rare occurrence in rifle wounds, 
while not unfrequent in gunshot wounds. This is owing to the fact 
that, in the latter case, the projectile is generally weak in force, and 
possesses an irregular shape and keen margins. This was especially 
the case with example Xo. 15, in which although the shell-fragment 
was wedged into the surgical neck of the humerus, yet the fissures 
being limited to a small part, the hone was not entirely broken. Also, 
in Xo. 22 radiating fissures were produced in the bone for a little dis- 
tance, no shell-fragment remaining behind. This was perhaps because 
the fragment being rather large (from the size of the wound we infer 
that it was not small), only a part of it penetrated the tissues and hit 
the bone inflicting merelv a slight iniury owing to insufficiency of 
force, and that a larger part of it remaining outside, it fell off of its 
own accord. A remarkable instance of a shell-fragment partly pene- 
trating the tissues, the rest remaining outside, occurred in example 
No. 16. The fragment struck the front of the inner ankle of the 
right foot, reaching down to the bone, but one half of it remained ex- 
posed, so the injured man pulled it out by himself. The 22nd and 
11th examples of these wounds, and 6th example of contused wounds 
by shell fragments, and 1st, 3rd, and 4th examples of contused 
wounds by iron pieces are almost the same in their nature, so that it 
is hard to decide whether they ought really to be classed as contused 



31(5 BLIND AND PEXETUATIXG WOUNDS. 

wounds or as blind, and for the present they are classified according to 
the names reported from different ships. The eight cases of penetrat- 
ing wounds of the skull in the 1st example all died instantaneously 
except one, and it is doubtful whether the shell -fragments really pene- 
trated into the skull or not, however, there is no means of investigat- 
ing the condition of the wounds, as the reports on them are so brief. 
One case, which survived for a few hours received 3 lacerated wounds 
in the forehead, all attended with fractures of the bone ; one near the 
border of the hair communicated with the cranial cavity as is seen in 
the illustration of case No. 45; and a part of the bone being missing 
the crushed brain substance came out of the hole together with blood. 
The aperture in the skin compared with those of the other two wounds 
was narrow, so that it might as well lie regarded as a penetrating 
wound ; but that could not be certainly affirmed, as the location of the 
shell-fragment was not ascertained. However, considered in another 
way, it may be explained thus : the cracks of the hone extended over 
a pretty wide area, so that they seemed to have been ] reduced simult- 
aneously with the other two wounds by a very heavy shell-fragment. 
Moreover the hole in the skin was not large, vet presented a lacerated 
form, so from all these facts, we may infer that it may not have been 
a penetrating wound, but a so-called contused wound attended with 
fracture, and that the loss of a part of the bone was because of the 
falling in of the broken pieces of bone, by which the brain substance 
was also injured. Example No. 27 also, though the location ol the 
shell-fragment was not ascertained, was obviously a penetrating wound. 
Fi.r the skin hole on the forehead had the appearance of a small lace- 
ration, and the bone was perforated with a round hole some 1 cm. 
in diameter, as is shown in the illustration of the clinical history, 
with cracks neither in the inner nor on the outer plates of the bone 



BLIND A\"I> PENETRATING WOUXD". rU7 

around ; so if is plain that this must have been caused by a pene- 
trating wound. What was the actual form of the fragment, can of 
course not be ascertained mow, yet as shell-fragments have as a rule 
irregular shapes, with several edges, and are never so round and 
smooth as bullets, we can easily imagine that the shell-fragment that 
produced the wound in question was likewise of an irregular shape 
The fact that the wound in the forehead was almost round, and that 
the inner as well as the outer plates sustained no cracks, proves thai 
the shell-fragment was very weak in force. Even with bullets, they 
produce such simple lesions to hone when they come from a great dis- 
tance, and with greatly impaired velocity. For the same reason, it 
seems that this fragment, being weak in force, could scarcely penetrate 
the frontal hone, hut as it spent all its force, it stopped near the dura 
mater without injuring the brain substance. There may occasionally 
he cases of no occuiTence of cerebral symptoms even when the frontal 
lobes were injured, hut in the present case the fragment seems not 
to have entered the cranial cavity as no foreign body was found after 
the trephining. At any rate, it is very strange that no brain 
symptoms occurred for some days after injury. Bui unfortunately 
the wound fell into suppuration and an abscess was formed 
in the skull, from which the patient died, the operation proving 
ineffective. 

The instances of the presence of pieces of cloth in the wounds 
were Nos. 10, li, 14, 23, and 28. In 3 of these cases, the shell- 
fragments had pieces of cloth sticking to one side only. It can easily 
he seen that this is not only the case with the shell-fragment, but also 
with an iron or wooden piece having a very irregular shape ami 
coarse surface, when striking a, part covered with cloth ; and in most 
of the blind wounds received in those parts of the body covered with 



318 KLIXD AND PENETRATING WOUNDS. 

clothes, this was undoubtedly the case even in the instances where 
no record is made of the presence of cloth. For in the treatments 
during battle or directly after, there are nol a few instances in which 
though a piece of cloth was taken out of wounds, yet no record of it 

was made. Also there may have been cases in which such pieces 
were taken out when the wounds were washed afterwards, which 
however was not recorded having escaped observation of the surgeons, 
and accordingly much to our regret, it is impossible to discuss this 
matter statistically. 

Instances in which shell-fragments stopped beneath the skin on 
the opposite side, were seen in Xos. 12, 18, and 28. Of these, in 
Xo. L2, the shell-fragment was powerful enough to crush the femur, 
and in Xo. 18 it entered the side of the lumbar vertebrae breaking the 
ribs from the side of the chest, vet in neither case was there strength 
enough to pierce the skin from within. At first sight, such cases 
may appear to be exceptional, but the skin on the opposite side, 
having no support, can be stretched by pressure from within owing 
to its elasticity and a certain force is needed for piercing it through, 
and consequently, cases in which shell-fragments stop beneath the 
skin on the opposite side are not regarded as curious in military 
surgery. 

There was a case in which several shell-fragments were found 
lodging in a single wound. This was seen by the blind wound of 
the right foot in example No. 20. It was not that three fragments 
of shell in the wound entered at one time a single fragmenl entered 
the wound and split into three on striking the hone. Such examples 
were found in other cases. 

A case in which cause of death was probably due to haemorrhage 
was sei n in example No. 9. This was indeed a serious wound in the 



BLIND AND PEN KTRATING WOUNDS. 319 

neck ; the trachea, oesophagus and carotid artery were rent open, but 
no lesion was found in the cervical vertebrae, so instant death should 
not have occurred unless the right common carotid artery had been 
injured. This case will lie further discussed later on. 

Example No. 21 was a case of a penetrating wound in the nasal 
bridge. The wound communicated with the maxillary sinus, and 
destroyed the inner wall of the right orbit causing a contusion >•!' the 
eye-ball and detachment of the retina, complicated with small blind 
wounds, one below the lower margin of the right orbit, and one 
on the right cheek. Subsequent occurrence of obstinate anaesthesia 
in the right cheek and temple, was due to the injury of the cutaneous 
branches of the third division of the trifacial nerve, accompanied the 
reflex paralysis of the auricula-temporal branches. Such paralysis is 
not of rare occurrence in gunshot wounds. 

Penetrating wounds of the abdomen were shown in Nos. 2, 3, 4 
and p. The patients all died except one. The size of the wound was not 
recorded in one case, but it destroyed the anterior superior spine of the 
right ilium ; another case had a round aperture 3 c. 111. in diameter 
near the umbilicus ; and the third had also a round orifice the size of 
a 2 sen copper below the umbilicus. As the abdominal walls yield 
to a great extent by pressure it is frequently observed that a fragment 
larger than the wound orifice has entered into the cavity. The 
two instances above mentioned in which the sizes of the wound orifi- 
ces are recorded, were similar round holes some 3 c. m. in diameter, 
and we may infer that in both eases the shell fragments were not 
small. Moreover, they must have injured the abdominal organs, 
as they certainly had irregular angular shapes ; and it is obvious that 
all cases were serious. The instant death, however, in these cases 
should not be attributed only to injuries of the abdominal organs, 



320 BLTXD AXP PEXETR\TIX<; wH'xns. 

but also to the subsequent occurrence of a severe shock or internal 
haemorrhage, though unfortunately the results of investigation were 
not sufficient to show the real cause. In such wounds, a severe shock 
may be the sufficient cause for instant death, so it is not necessary to 
attribute the death to hemorrhage. Also in example No. 2 in which 
instant death did not ensue, it is not certain whether there was a shock 
at the time or not, as this ease occurred on board the Matsushima where 
numerous persons were either killed or injured at one time, and the 
surgeons were consequently too busily engaged to spare time for re- 
cording each case minutely. Indeed none of the first symptom- of 
any cases in that vessel can be clearly assertained, but the surgeons 
concerned in the treatment at that time told us afterwards, that there 
were many cases of violent shocks among the patients suffering from 
burns and other wounds. The position and size of the wound in No. 
2 were nearly the same as those in Nos. 4 and 5. and it is plain that 
in this case also the abdominal organs must have been hurt ; the dif- 
ference in the fate met with, may be attributable to the different severi- 
ty of shock or internal haemorrhage, though it may also be due to the 
condition of the injuries of the abdominal organs, in which in spite of 
severe injury to the internal organs, instant death can mostly be 
avoided if the shock lie slight, without copious internal haemorrhage 
at the same time. Such examples are seen elsewhere and will he 
dealt with further on. 

The penetrating wounds of the chest by shell-fragments are 
shown in Nos. 11, 19, 28, 29, and 30. En the No. 11. the shell-frag- 
ment may not, as lias already been pointed out, have penetrated into 
the thoracic cavity ; but in No. ID, the fact was plainl} 7 otherwise, 
that is. the fragment entered the cavity below the left scapula smash- 
ing the ribs, and consequently there ensued intense pain in tin' left 



BLIND AND PENETRATING WOUNDS. 321 

hypochondriac region, dyspnoea, and subcutaneous emphysema around 
the wound, high temperature, and after a few days bloody expectora- 
tions. From the presence of severe pain in the hypochondriac region 
and subcutaneous emphysema, we may infer that the shell-fragment 
dropped into the pleural cavity alter breaking the ribs; it is plain 
that the lung was injured, however from the absence of haemoptysis 
at the time of injury it can not be thought that the fragment 
injured the lung deep down. Probably the lung was either 
superficially hurt by some broken pieces of the ribs, or by a shell- 
fragment which did enter deep into the organ. The bloody ex- 
pectorations which appeared a few days after ami lasted pretty long, 
were probably consequent on the circumscribed pneumonia ensuing 
around the wound, and the disappearance of the pleurodynia was 
probably due to the fact that the shell-fragment was encysted in 
inflammatory products. In example No. 30, which occurred on the 
Matsushima, the ribs were certainly broken, and it was likewise 
evident from the existence of subcutaneous emphysema and pneumo- 
thorax that the lung was injured, but in the absence of any detailed 
record of symptoms, it is very uncertain whether the shell-fragment 
penetrated into the lung or not. The death of the patient on the 
following day, was because of the combined effects of extensive burns 
received at the same time. 

The instances in which subcutaneous emphysema resulted were 
three, that is. Nos. 11. ID and 30 ; and further, in the two examples 
28 and 29, tlie 10th rib was broken. Yet as will be hereafter shown, 
the lung was injured only in one case. There was also a penetrating 
wound of the thoracic wall breaking the 5th and Gth i.bs on the left 
side, in which it could not be ascertained whether the cause was :t 
shell-fragment or an iron-piece, in this case, also the lung seemed 



322 BLIND AND PENETRATING WOUNDS. 

not to have been injured. Besides these, there were .seven eases of 
perforating wounds of the chest, all of which resulted in instant death 
so that we need not discuss about the existence of emphysema. To 
sum up, the penetrating and the perforating wounds of the thoracic 
cavity are 13 in all (cases of blind wounds of the thoracic wall in 
which the iron-pieces stopped at the ribs, an' not counted in this 
number). Subtract from these seven cases of instant death, and there 
remain 6 cases. Of these (i cases. 2 seemed to have escaped injury to 
the lung, and of the remaining 4 cases of lung injury, 3 were affected 
with subcutaneous emphysema. Emphysema is rarely met with in 
military surgery. Neuderfcr says lie met with only one in '20[) cases 
of penetrating and perforated wounds of the chest, and Otis mentions 
no more than 38 our of 8,715 cases of the same wounds in the lungs 
which occurred during the Civil war in America. For in rifle wounds, 
the bullets have as a rule, a high velocity, so that not only do they 
frequently make perforated wounds, hut even those bullets which are 
weakened in velocity and onlv strong enough to inflict penetrating 
wounds, enter into the lungs owing to their shape, which is peculiarly 
convenient for penetration, and produce gaping wounds in the lungs 
as well as the chest wall. They thus make it easy for the air to escape 
through the wounds, and hence it is rarely that emphysema is caused 
by bullet wounds. On the contrary, shell-fragments are as a rule 
weak in velocity, so that not a few of them have exhausted themselves 
as soon as they have broken the ribs: also, owing to the irregularity of 
their shapes, they arc often unable even to pass through the broken bones. 
Thus, in wounds from shell-fragments, the lungs are hurl mostly by 
broken pieces of the bone itself, and accordingly, the wound orifice of 
the lungs and thai of the chesl wad do QOl correspond with each other. 
Hence the air will probably be hindered from escaping and thus we get 



BLIND AND PENETRATING WOUNDS. 323 

a comparatively frequent occurrence of emphysema. Moreover, shell- 
fragments mostly strike the body at an oblique angle as will be seen 
in the foregoing 3 instances. This is surely another cause of obstruct- 
ing the escape of air out of the chest. It is therefore not strange that 
emphysema should be of more frequent occurrence in the wounds 
caused by shell-fragments. Of the afore said 3 instance.-, one was, as 
has been mentioned, certainly attended with haemoptysis, in another 
bloody expectorations began a few days after the injury. In the re- 
maining case, we have no record of haemoptysis, and can affirm that 
it did not actually occur, for so important a symptom could not have 
been left unrecorded if it had existed. Thus, in each of the 3 
cases, the lung injury was certainly slight and superficial, and we thus 
infer that subcutaneous emphysema is more likely to ensue in slight 
injuries of the lungs. 

Xos. 2(S and 29 were eases in which though the shell fragment 
entered through the thoracic walls, it finally reached the abdominal 
cavity : in No. 28, the fragment entering the 9th intercostal space 
broke the 10th rib, then injuring the liver, arrived beneath the skin 
on the right side of the first two lumbar vertebra'. There existed no 
signs indicating lung injury, but it was beyond doubt that the liver 
was wounded, for from the wound orifice escaped a fluid mixed with 
bile pigments, and from time to time jiieces of hepatic substance were 
discharged ; further, on probing the wound orifice it was found to 
communicate with the liver. However, severe paroxysmal pain in 
the right shoulder, which often attends hepatic injury did not occur, 
nor was there any jaundice or hiccough. The wound orifice at first 
seemed inclined to suppurate, but afterwards it made ry favorable 
progress and was at last healed. Xo. 29 was a case in which the 
shell-fragment entering by the Nth rib in the left axillary line took 



324 BLIXD AXIi PENETRATING WOUNDS. 

a course obliquely downward, breaking the 10th rib. It was plain 
that the shell-fragment had fallen into the abdominal cavity, from 
the fact that intense pain was complained of in the abdomen on the 
following day, resulting in a serious peritonitis ; and from the pre- 
sence of bloody expectorations, which shewed that the lung must have 
suffered more or less injury. What abdominal organs were injured. 
is not certain, but the intestines were certainly hurt, for there existed 
signs to the effect. This is therefore another instance of injury to 
abdominal organs, which did not result in instant death. 

(2) Blind and penetrating wounds caused by iron pieces. These 
wounds numbered 12 occurring in Id persons, of which cases of some 
interest a iv as follows : 

1st example: — One of the fragments of a funnel broken by a shell, inflicted a 

lacerated wound 6 cm. long and 2 cm. wide, on the right side of the chest extending 
from the 7th to the 9th rib near the median line. It measured 2 cm. in depth re- 
taining an iron-piece at its bottom, which partially protruding beyond the wound 
orifice, was extracted by the injured person. The bottom of the wound reached the 
costal cartilage without injuring it, and the wound was healed in 4 weeks. (No. 140.) 

2nd example : — From the same cause, a biiud wound below the outer part of the 
right clavicle was received. The wound orifice was 2 cm. in verticil diameter, 1.5 
cm. in lateral diameter and cm. in depth, the canal took an upward course, and 
an iron-piece was recognised wedged into the clavicle, which, being extracted, proved 
to be of an irregular square shape 2 cm. long, 1 cm. wide, and 3 m.m. thick. The 
clavicle was found only partially broken, not completely separated. The wound was 
healed in weeks. (No. 181). 

3rd example : — At the same monieut with the last, a blind wound was inflicfo I 
by an iron-piece, which extended from the left side of the nape to 1 1 1 « - base of the skull. 
By this the brain was injured, and the man died on the spot. (No. 60.) 

4th example: — By a shell, both thighs were mutilated at the middle, and above 
the mutilated part of the right thigh another lacerated wound 5 cm. long was 
sustain, 1 in which was retained a large fragment of a stanchion. 13 cm long and 7 
cm. in diameter. The man died after a short time from the shock, i No. 264.) 



BLIND AND PEXEIRATIXO WOTJXDS. 325 

5th example : — Both legs were mutilated by a shell, and at the .same time a 
large blind wound was indicted on the thigh, in which 3 large fragments of the funnel 
casing were retained. The injured man expired in a short while. (No. 290.) 

If 1:2 blind and penetrating wounds by iron pieces be proportioned 
to GO, the total number of various wounds occasioned by the same 
cause, they will bear a ratio of 20.00 per cent, which is not half so 
large as 41.(57 per cent of the contused wounds, and is a little larger 
than 1G.G7 per cent of the abrased wounds. This is because as iron- 
pieces are not thrown about with much velocity, those which have a 
large hulk may indeed acquire force in consequence of their weight, but 
their size will prevent them from penetrating ; and those fragments 
which are small and capable of penetrating, lack weight and conse 
quently force. Therefore, it is not often that any kind of iron-pieces 
penetrates the tissues. This is the reason why they frequently produce 
such injuries as contused wounds rather than penetrating ones. In 
the 1st example above mentioned, the wound orifice was as wide as if 
it had been produced by an iron-piece living obliquely : and the wound 
reached the costal cartilage without injuring it; and in the 2nd 
example the iron piece wedged itself into the clavicle without parting 
it completely. All these facts prove that iron-pieces are generally 
very weak in force. Besides, with the exception of the 3rd example 
of blind and penetrating wounds, there was not a case in which a bone 
was broken. This is because those fragments which penetrated into 
the tissues were small and wanting in force. However, with contused 
wounds caused by iron-pieces, there are many cases attended with 
fracture of bone. This is because some of them had a great weight 
and force owing to their size though their shape prevented them from 
penetrating into the tissues. The 3rd example lacks a minute record 
of the conditions of the wound orifice &c, so that we can not explain 



32(5 BL1XD AXI> PENETRATING WOUNDS. 

the ease exactly, yet the iron-piece niusT have been exceptionally force- 
ful as the base of the skull was smashed, and as The injured person 
was then rlose by the funnel, of which the piece was a fragment : also 
the shape <>f the fragment probably had much to do with its Jeep 
penetration. The 4th example was a very interesting one, — a lacerat- 
ed wound .") cm. long in the upper part of the right thigh, within 
which was retained a large fragment of the stanchion 13 cm. long 7 
cm. in diameter (see the illustration in the clinical history). The 
entrance orifice of the blind wound produced by an iron-piece should 
usually be smaller than the piece itself, as in the case of the orifices 
made by shell-fragments, whenever it strikes at right angles a part 
rich in soft tissues ; and if the velocity of the iron-piece is weaker 
than rhat of a shell-fragment, this will lie more particularly the case. 
The 4th example proves This more Than sufficiently, for The iron-piece 
was so large compared with The size of The wound orifice. That it an as 
hard To conjecture how it could have entered through such a hole. 
Whether the iron-piece struck the skin with its long axis, or otherwise 
is not known, vet at any rate its size compared with the hole is in- 
comparably large This was probably because it had greatly stretched 
the skin by pressure before penetrating it. otherwise the hole could 
not have been so comparatively small. And so remarkable an exten- 
sion of skin should not lie attributed onlv to the size and weight of 
r lu- said iron-fragment, but ir must also have borne some relation to 
the reception of a mutilated wound in the neighborhood. For. the 
part jusl below the present wound had been entirely mutilated by a 
shell, and as the velocity of a shell should be greater than that of an 
iron piece, so the mutilated wound must have been inflicted previously 
to the presenl injury, be it ever so little earlier. therefore, at the 
time when the iron-piece struck the skin, the latter was certainly 



BLIND AND PENETRATING WOUNDS. 327 

capable of being stretched by pressure, owing to the free movement of 
the tissues which had been freed from connection below, and besides, 
the relaxation of the muscles produced by the very severe shock 
which inevitably follows a mutilated wound, may also have had 
something to do with this phenomenon. The several reasons above 
mentioned, will perhaps account for so great a difference between the 
size of the wound orifice and of the iron-piece. The 5th example 
which bore a resemblance to the last case, was one in which 
both legs were mutilated by a shell, and in the right thigh were 
concealed .'> large pieces of the funnel casing as are shown in the 
illustration in the clinical history. The orifice of this wound was 
also smaller than that of the iron-pieces ; however, its exact length 
was not known, for the difference not being so marked as in the 4th 
example, thed intension of the wound was not measured. This and 
the last wounds were inflicted by the same cause, but as the 
weight of the iron-piece was much smaller than in the 4th example, 
it naturally stretched the skin in a lesser degree. Besides, in this 
case, though the mutilated wound was in the leo-, the resistance 
of the subcutaneous tissues was not so much lessened as in the 
last example, and thus the difference between the sizes of the orifice 
and of the iron-piece was not so great as in the 4th example. 
The division of the piece of iron into three must have taken place 
after the iron entered the wound. Besides, there were one or two 
blind wounds produced in parts rich in soft tissues, hut with 
them, the difference between the size of the wound orifice, and 
that of the iron-piece was not so marked, for as the fragments 
entered the tissues in a slanting direction their sizes Avere almost 
the same. 

(3) Blind wounds caused by wooden splinters. These numbered 



328 BLIND AND PENETRATING WOUNDS. 

5 occurring in 5 persons, except those mentioned below, the rest were' 
punctured wounds by small wooden splinters. 

1st example: — A hostile shell glanced off and broke the dock from side to side, 
when the person happened to be in the neighborhood. Such exposed parts of the 
body as the face, neck, and hands received numberless tine wooden splinters, so that 
the skin presented the appearance of a hedgehog ; and at the same moment several 
large and small contused wounds were inflicted by iron and wooden pieces on the 
face, neck and limbs. All of them were however, completely heale 1 in two weeks. 
(No. 98.) 

2nd example : — A 80.5 cm. shell exploded in the next room, and a big wooden 
splinter came flying wedged into the left sacro-iliac joint. The wound orifice was 5 
cm. long and 3 cm. wide; the margins were very irregularly lacerated; and the 
wooden piece at the bottom being firmly wedged into the joint could not be moved 
when the surgeons tried to take it out. After a time, both legs became paralyzed, 
and urine passed unconsciously mixed with blood and pus. After admission to the 
hospital, an attempt was twice made to extract the wooden piece, but being extremly 
firm, it was only partially pulled out, and with it came broken pieces of the bone. 
The paralysis of the legs increased, urine and fasces passed involuntarily, and the 
wound suppurated, the temperature fluctuating between 3S^ and 39° C. The patient 
died after 2 weeks from exhaustion. (No. 1G7.) 

If the 5 blind wounds caused by wooden splinters be propor- 
tioned to 58, the total number of various wounds from tin' same 
cause, they hear the ratio of 8.62 per cent, which is much smaller 
(ban 39.66 per cent of the contused wounds from wooden splinters, 
22.41 of the abrased wounds from the same cause and 29.31 of the 
contusions also from the same cause. This is because the scattered 
wooden splinters lacking- in weight and force have not power enough 
to penetrate into the tissues. The exceptional cases were those in 
which very fine wooden splinters like tooth-picks stuck into the skin. 
The 1 -t example above mentioned was no more than one of those 
cases, ii was however remarkable on account ol the wonderfully 



BLTXD AXD PEXETRATIX.t WOUSDS. 829 

nutnei-ous punctured wounds on exposed parts us the face, neck, and 
hands. The 2nd example is an extremaly rare cass in which a large 
wooden splinter firmly wedged itself into the left sacro-iliac joint, 
breaking the bones and probably injuring the cauda equina, followed 
by the complete paraplegia of both lower limbs and paralysis of the 
bladder and rectum. As this wooden piec3 was very firmly in, several 
forcible attempts to pull if out were made, but in vain, only a broken 
pari of it being removed. The size of the wooden splinter was not 
ascertained, yet it seems to have been some 5 or 6 cm. in diameter, 
and being so firmly wedged into the joint, it is certain that it was 
not weak in force. Wooden pieces are it is true, generally weak in 
force ; but they differ in weight and consequently have not the same 
force as shells ; so when a .splinter is pointed at one end and con- 
sequently fit for penetration, this kind of wound may be expected. 

(4) Blind wounds : uncertain whether caused by shell-fragments 
or by iron-pieces. These are 3 in all occurring in 3 persons, as is 
shown below. 

1st example : — A shell burst, striking the iron-pillar on the deck: broken frag- 
ments of the shell and the pillar scattered, and inflicted following wounds: first, a 
blind wound on the left side of the chest, breaking the 5th and 6th ribs <>n the axil- 
lary line, accompanied with heavy haemorrhage. But the lung seemed not to have 

1 ii injured as there was no hsemopty.sis. What was the size of the fragment could 

not he known as its location was not ascertained. Secondly, in the calf of the left leg 
and on the outer side of the left ankle joint there were blind wounds in which iron- 
fragments were retained. The temperature ros i to 38° C. and blood accumulating in 
the left pleural cavity, signs indicating increased pressure in the chest, supervened, 
and the patient died next morning. (Xo. 143. "I 

'2nd example : — A shell hurst against the gun-support, and the fragments of the 
shell and of the broken iron inflicted a penetrating wound on the left side of the 
forehead. Also the upper pirt of the right thigh was mutilated and the injured man 
died on the spot. (Xo. 65.) 



330 BLIND AND PENETRATING WOUNDS. 

3rd example : — This is the case of the blind wound of the left 'leg mentioned in 
the 18th example of blind wound-; caused by shell fragments; it could not he ascert- 
ained whether the foreign bod} - extracted from the wound was a shell-fragment or 
an iron-piece. 

The blind wounds of uncertain cause whether by shell-fragments 
or in in-picces are the three above mentioned. As regards the 1st 
example, tbe wounds in the calf of the left leg, and on the outer- 
side of the left ankle joint it is sure, were caused by iron-pieces, 
lint the cause of that on the left side of the chest was not certain, 
In the latter wound, the 5th and 6th ribs being broken haemorrhage 
was profuse, but inferring from the fact that there were no signs of 
lung-injury, or of the entrance of a foreign body into the thoracic 
cavity, and that two ribs were broken indicating the causative objeel 
not to have been small, we should think that in the present wound, 
as in the 11th example of the blind wounds caused liy shell frag- 
ments, the causative missile did not penetrate entirely, but in part, 
that it broke the ribs, and fell off of its own accord. Though in the 
clinical history of this case the size of the wound orifice was not 
slated, we are told that it was a wide lacerated one. which fact 
evinces that the wound was not inflicted by a small fragment falling 
down iii a slanting direction. The death on the following day seems 
to have been occasioned by internal haemorrhage, which we shall 
further discuss in the next chapter. As for the 2nd example, the 
mutilated wound of the upper part of the right thigh was certainly 
produced by a shell-fragment, but with the injury in the forehead 
it is not known, which of these two objects, a fragment of shell or iron 
metal, was the cause. If the object be ascertained to have entered the 
skull, we should say judging from its force, that ii was a shell-frag- 
ment, but whether it did actually penetrate or not is likewise doubt- 



BLIND AND PENETRATING WOUNDS. 331 

ful. The instant death of the injured person was natural, as both the 
wounds were very serious. The 3rd example has been already dis- 
cussed among the wounds by shell-fragments. 

(5) There is one case of blind wound produced by buck-wheal 
husks : — 

An enormous sh;ll bnrst on the lower deck and the explosion gas, shell-fragments 
and other kinds of broken pieces welled up out of the sky-light, when an irregular 
round blind wound 3 cm. in diameter was inflicted on the back of the middle of tbe 
right forearm. Tbe wound was o cm. deep retaining foreign bodies at tbe bottom, 
which, being taken out proved to be 6 or 7 buck-wheat busks. Tbe wound was heal- 
ed in 7 weeks. (No. 221.) 

From the existence of buck-wheat husks in the wound, they were 
regarded as the cause of the injury, but the wound aperture which 
was an irregular round one 3 cm. both in diameter and depth could not 
have been produced merely by buck- wheat husks. The husks which 
had been used as the stuffing of a pillow can not be regarded as 
having produced a single hob- of such a size, even had they been 
driven in a large mass. Then 'fort', we should say that tbe husks 
entered the tissues sticking to a shell-fragment, or an iron-piece and 
were left behind, while the main object came off owing to its partial 
penetration into the tissues. 

(6) There was one case produced by a bullet, but whether it 
was from a musket or Gatling gun was not known. The wound was 
a small blind wound merely piercing the skin. 

The blind and penetrating wounds numbered 79 in all as stated 
In-fore, of which 57 were caused by shell-fragments. 12 by iron-pieces. 
5 by wooden splinters. 3 uncertain, whether by shell-fragments or by 
iron-pieces, and 2 of which one was by a bullet and tbe other probably 
by buck-wheat husks. Proportioned to 629 the total number of vari- 



332 BLIN'D AXI) PKXETRATIXG WOUNDS. 

oiis wounds, they bear ji ratio of 12.56 percent, which indeed is by 
far smaller than the ratio of contused wounds, but occupies the high- 
esi number among nil other kinds of wounds. This is the point which 
shows the difference between the nature of shell "wounds and bullet 
wounds. The bullets on account of their velocity and shape were 
suited for penetration, thus they generally produced perforating 
wounds, while shell-fragments as well as iron or wooden pieces have 
an irregular shape and are not forcible enough to pierce through an 
object, and therefore those which are heavy, and accordingly possess 
much force produce mutilated wounds, those which rank next in 
hulk, and arc noi so forcible in power cause mostly contused wounds 
or contusions, and those which are small in bulk, and more or less 
strong in velocity, or those which are pointed at the end, anil are suited 
for piercing, can only enter into tissues, vet owing to insufficiency of 
force and unfavorable shape, mostly stop when they meet with tissues 
offering much resistance ; hence the result is a. blind or penetrating 
wound. Therefore, such wounds as perforating ones are of very rare 
occurrence. However, the contused, blind and perforating wounds do 
not depend for their production only on the velocity, size, and shape of 
the projectiles, hut also on the conditions of the part struck. In parts 
rich in soft tissues, as the thigh, and parts covering soft internal organs, 
as the abdominal walls, which are easily penetrated, even those mis- 
siles which produce contused wounds elsewhere may often cause blind 
or penetrating wounds. That there were nine cases of penetrating 
wounds in hard parts like the head, may appear at first sighl incompa- 
tible with the above statement ; however, not only can these 'J cases 
not be certainly described as penetrating wounds, hut they were all 
inflicted in the proximity of shell-explosions so the fragments, even 
though small, may he regarded as not having been weak in force, and 



PERFORATED WOUXDS. 333 

it is nothing abnormal that they should have all been penetrating 
wounds. Again, in the clinical history there were several cases stated as 
blind wounds where the wound was very deep but no record was given 
of the existence of shell-fragments. In these cases, it could not 
be ascertained whether the wounds were healed with the fragments 
remaining, or whether the wounds merely resembled blind ones, but 
were actually contused or lacerated wounds. As we have already 
said, there are cases in which the missiles striking a part poor in 
subcutaneous tissues, penetrated a little distance and stopped there, 
and then came off of their own accord, but cases of deep wounds with 
no shell-fragments in them can not be regarded as true blind wounds. 

5.-PERF0RATED WOUNDS. 

(1) There is one case of perforated wounds caused by an entire 
shell, as is seen in the man killed on the fore-top of the Akagi. 
According to the report made by the Chief Surgeon of the ship, he 
was pierced through the abdomen from the loins, the lumbar vertebrae 
were smashed and the aorta ruptured (case Xo. 171), possibly by a 
shell from a light-machine gun of some 47 m.m. But another person 
who was injured at the same place and time (Xo. ^35) seems to have 
been struck by a fragment of a shell, as was seen from the powder 
grains sticking in dots around the wound of the hand. This is a 
point admitting of doubt, for on the one hand unless a shell exploded 
in the neighborhood, such intrusion of powder grains would not have 
occurred ; but on the other, allowing that such explosion happened. 
it is strange that the margin of the wound in the hand was the only 
place covered with powder grains which ought to have been scattered 
more widely, so as to involve the face and other exposed parts, or to 
inflict burns there. The only explanation that can be offered is that 



334 PERFORATED WOUNDS. 

all the other parts of his body were protected, the hand alone was 
exposed on the side from which the explosion gas came. Seeing that 
there also existed abrased wounds on several parts, we can venture to 
say that the person was struck by the fragments of a shell that burst 
in the neighborhood, and that the wounds on the parts covered with 
clothes, were probably caused by the shell-fragments rebounding from 
some other objects. We may therefore reasonably assume that the 
perforating wound of the abdomen was probably inflicted bv a large 
fragment of the shell. The report that it was produced by a shell about 
47 m. m. is no more than a mere conjecture based upon the size of 
the wound aperture. 

(2) The perforated wounds produced by shell-fragments num- 
bered 33 in all, occurring in 30 persons, of those having some interest 
will be briefly described below. 

1st instance : — A perforated wound in the ball of the thumb had on the palm a 
round entrance aperture some 2 c. m. in diameter, which running along the radial 
side of the 2nd metacarpal bone found exit on the back of the hand. The exit was 
somewhat large presenting a lacerated appearance. Besides this, there were burns 
on both forearms. (No. 227.) 

2nd instance : — A large perforated wound on the right leg ; that is, at the upper 
part of the inner side of the leg, was a large irregular oval entrance aperture 15 cm. 
in length, which found its exit in a star-like shape 7 cm, long and 4 cm. wide on 
the back of the middle of the same leg (See the illustration in the clinical history). 
After a time, the healing process was gradual, and completed in 5 months, but owing 
to the cicatrix, the circulation of blood was somewhat obstructed so that the foot was 
inclined to swell, but friction and local bathing were resorted to, and the patient 
completely recovered, and returned to duty. (No. 282.) 

3rd instance — Perforated wound on the right side of the chest breaking the 
4th rili and found exit on the back causing a heavy 1 Hemorrhage. In addition, the 
man sustained burns on the head and face, and he died on the spot. The size of the 
wound aperture was not known. (No. 148.) 



PERFORATED WOUXDS 335 

4th instance : — A large perforated wound from the left side of the chest to the 
right side of the hack was sustained, accompanied with another perforating wound 
from the inner side to the hack of the middle of the left thigh, and hums on the face 
and neck. He was killed on the spot. The sizes of the perforating wounds were not 
recorded. (No. 151.) 

5th instance : — A perforating wound at the upper third of the right thigh, the 
femur was broken and the lnemorrage profuse. The entrance orifice was an irregular 
square shape 3 cm. in diameter, and the exit a lacerated form hardly 3 cm. in dia- 
meter. Besides, there was a contused lacerated wound 4 cm. in length on the right 
shoulder. He died on the spot. (No. 260.) 

6th instance : — A large perforating wound from the right side of the chest to the 
back was inflicted, accompanied with a similar wound iu the middle of the left upper 
arm. The injured man died on the spot. The size of the wound was not recorded. 
(No. 149.) 

7th instance : — A perforating wound from the right side of the thyroid cartilage 
to the nape of the neck corresponding to the second cervical vertebra was sustained, 
and it seemed, as if the right eye-ball had been hit by a small shell-fragment, the 
cornea and sclerotic were destroyed discharging the contents of the eye. Though the 
carotid artery was not injured, haemorrhage was profuse, at first the mind was firm 
without signs of shock, but after a time the temperature rose accompanied with nausea 
and vomiting, and the patient became drowsy, finally falling into coma, he expired in 
little more than an hour after the injury. (No. 128.) 

8th instance : — A perforating wound from the outer part of the right clavicular 
region to the right shoulder was sustained, accompanied with a blind wound in the 
front of the right thigh, and three abrased wounds on the inner side of the left leg. 
The entrance orifice of the wound of the clavicle had an oval shape the size of the tip 
of the thumb, the exit was smaller and presented a lacerated form ; the outer part of 
the clavicle was broken. In the wound 5 pieces of bone were found and extracted. 
The wound healed in 3 months, but the muscles became emaciated, the grasping 
power was greatly weakened and treatment being of no avail, the patient had finally 
to be invalided. (No. 193.) 

9th instanee : — A large perforating wound from the right side of the chest, to 
the left part of the back was sustained, breaking the 3rd rib. The injured man died 
on the spot. The size of the wound aperture was not recorded. (No. 147.') 



336 PERFORATED WOUXDS. 

10:1) instance : — Perforating wound of the upper arms, penetrating wound on tlie 
left side of the chest, blind wound on the back, and several contused wounds on the 
back and thighs were sustained. The perforating wound of the right arm pierced 
through it at the middle from back to front, breaking the bone. The entrance orifice 
had a lacerated form about 2.5 cm. in length, and the exit had the same shape and size. 
The left arm was perforated in its lower third, passing from the posterior surface to 
anterior ; both the entrance and exit wounds had lacerated forms though somewhat 
smaller than the one on the right arm. In both cases, the humerus was broken, and 
the orifices in front of the bone had their soft tissues extensively severed, and 
many small pieces of the bone were found sticking in the muscles. The brachial 
artery was i itact in each case. Afterwards both wounds fell into suppuration, and 
frequently discharged minute particles of the bone together with pus. On the right 
arm, paralysis of the musculo-spiral nerve ensued. After the lapse of 6 months, the 
wound of the left arm was healed, followed by that of the right. However, the 
paralysis of the musculo-spiral nerve remained as before, and the muscles supplied 
by it wasted, so that the grasping power was entirely lost. Tnere was no hope of 
recovery, accordingly the patient was discharged after 15 months in the hospital. 
(No. 209.) 

11th instance : — A large perforating wound from the left side of the chest to the 
right side of the abdominal walls was sustained. The injured man was killed on the 
spot. The size of the wound orifices was not recorded. (No. 145.) 

12th instance : — A large perforating wound from the lumbar region to the 
al lomen was sustained ; the lumbar vertebra were smashed. Besides, a large con- 
tused wound with fracture at the middle of the right thigh was received, the person 
was killed then and there. (No. 174.) 

13th instance : — At the lower part of the right forearm was sustained a mutilat- 
ed wound, and while the patient was receiving treatment in the surgery, an enormous 
shell burst in the room, indicting a large perforating wound on the right thigh. The 
length of the entrance orifice measured 18 cm. and the width 6 cm. The exit was 
of about the same dimensions, but a little smaller than the entrance orifice. The 
margins of the wound were irregularly lacerated ; the soft tissues inside it were ex- 
tensively severed, the fascia rent in various lengths, and the femur being smashed 
below the great trochanter, numerous pieces of the bone were found in the severed 
muse;. Afterwards, the skin and other tissues around the wounds sloughed, and 



PERFORATED WOUN'DS. 337 

pus accumulated beneath the periosteum of the femur. The temperature rose, and 
symptoms of traumatic delirium began. Amputation at the upper part of the thigh 
was performed ten days after the admission, but the patient died soon after the opera- 
tion. (No. 261.) 

14th instance : — A perforating wound from the hypogastric region to the loins. 
The injured man was killed on the spot. The size of the wound orifice was not 
recorded. (No. 1C9.) 

15th instance : — At the same moment with the above, a perforating wound in 
the hypogastric region. The injured man was killed on the spot. The size of tha 
wound orifice was not recorded. (No. 170.) 

16th instance : — A perforating wound on the back of the left hand, from the 
ulnar side of the 1st metacarpal bone, smashing the 2nd, 3rd, and 4th metacarpal 
bones with exit on the radical side of the 5th metacarpal bone. The entrance orifice 
had an irregular star-like form 3 cm. in diameter, and the exit a lacerated form 
about 3 cm. in length. Hremorrhage was profuse though not continuous. Contused 
wounds were also sustained on the back of the head and left buttock. The wound of 
the hand suppurated, and as the bones were irregularly broken, those which were 
heavily damaged were resected, and others not so much severed were sawn off at the 
broken ends, the unhealthy granulation in the wound being scraped away. Thus, in 
80 days after the injury, the wound was healed ; but owing to the loss of the meta- 
carpal bones, the man was dismissed. (No. 228.) 

17th instance : — A perforating wound was received on the inner side in the 
upper third of the right thigh. The entrance orifice had an irregular round form, 12 
cm. in diameter, and the exit which was situated behind the former had an irregular 
square form 4.5 cm. in length. The muscles and other tissues protruded, and the 
margins were irregularly lacerated ; haemorrhage was not heavy. Besides, there 
was an abrased wound on the abdomen. The wound of the thigh suppurated, and 
the tissues around the margin of the wound sloughed. The patient recovered after 
five months in the hospital. (No. 256.) 

18th instance : — There existed a grooved wound, 18 cm. in length, 3 cm. wide, 
and 1.5 cm. in depth, running transversely on the back. The one end of the wound 
passed under the skin for about 3 cm, making an exit below the acromion process of 
the left scapula. The exit had an irregular round shape 5 cm. in diameter, the 
margins being unevenly lacerated. The bottom of the grooved wound corresponding 



338 PERFORATED WOUNDS. 

to the entrance orifice was sharply cut and bled profusely. There was no injury to 

the scapula, vertebrae nor ribs. The wound was completely bealed in 4 months. 
(No. 142.) 

19th instance : — A perforating wound was received in the lumbar region. The 
lumbar vertebra? were broken, and several small blind wounds were sustained on the 
back. The person was killed on the spot. The size of the wound orifice was not 
recorded. (No. 172.) 

20th instance : — A perforating wound passing from the occipital region to the 
middle of the forehead was sustained. The injured man was killed on the spot. The 
size of the wound was not recorded. (No. 67.) 

21st instance : — A perforating wound was received in the uppermost part of the 
upper arm. The entrance hole was situated in the anterior surface of the arm and 
constituted a wound with loss of substance in an oval shape 5 cm. in diameter ; the 
margins were greatly lacerated including the deltoid muscle, and the wound passage 
found its exit on the posterior surface. The exit had a lacerated form being some- 
what narrower than the entrance hole, and the severed fibers of the muscle were seen 
protruding out of it. Also, below the lower margin of the left orbit was sustained a 
blind wound 1 cm. in diameter, which caused ha?morrhage in the retina. All the 
wounds were healed in 3 months after admission to the hospital, but owing to the loss 
of sight of the left eye, the man was dismissed from the service. (No. 103.) 

22nd instance : — A perforating wound was inflicted above the left elbjw. The 
entrance hole was an irregular wound with loss of substance measuring 6 cm. long, 
and 4.6 cm. wide, and the exit was a lacerated wound 2.7 cm. long. This occurred 
together with the penetrating wound of the abdominal cavity from the left side of the 
chest. (See No. 20th instance of penetrating wounds.) From this penetrating wound, 
the man died 10 days after. Though we can not assert with certainty, yet from the 
position and size of the wounds in the elbow and chest, they may be regarded to have 
been caused by one shell-fragment. (No. 162.) 

23rd instance : — A perforating wound was received passing from the back of the 
left ilium to the right inguinal region. The entrance hole was lacerated and about 6 
cm. in long diameter. The ilium was greatly damaged and the internal organs were 
injured, the exit was found above the Poupart's ligament: it was a hole some 8 cm. in 
length from which the intestines protruded. In the abdomen, several fragments of 
the bone were found the largest of which was a broken piece of the iliac-crest, 9 cm. 



PERFORATED WOUNDS. 339 

in length. The patient was firm in mind, without any sign of shock, hut incessantly 
complained of severe pain in the abdomen, rolling about and sweating profusely. In 
spite of the desire to pass urine, it was impossible. On introducing a catheter, 
only blood was drawn, indicating that the bladder was also injured. The patient died 
in 8 hours after the injury. (No. 173.) 

24th instance : — While standing on the bridge, the person received a perforating 
wound in the abdomen, and fell overboard being killed on the spot. (No. 168.) 

25th instance : — A perforating wound was inflicted on the lower third of the 
right thigh. The entrance hole had an irregular triangular shape, 3.6 cm. at the 
base and 2 cm. at each border, and the exit presented a small laceration as is seen in 
the illustration of the clinical history in which a part of the shell-fragment was shown 
to protrude. Within the wound two shell-fragments (shown in the illustration of the 
clinical history) were found. The wound was healed after a lapse of 3 months. 
(No. 257.) 

26th instance : — Two persons received perforating wounds of the chest at the fort 
of Lntsotsai from which they died on the spot. The size of the wounds was not 
recorded. (No. 146 and 151.) 

The perforating -wounds caused by shell-fragments numbered 33, 
which proportioned to 289, the total number of various wounds pro- 
duced by the same cause, bears only a ratio of 11.42 per cent, which 
is smaller than 33.56 of contused wounds, 19.72 of blind wounds, 
and 16.26 of abrased wounds. This is because as bus already been 
explained the shell-fragments which are the chief cause of the gun- 
shot wounds have an irregular shape and coarse surface and are not 
only unfit for penetration, but have a great variety of sizes. The 
large and consecpiently powerful ones frequently produce mutilated 
wounds, as rhey are unfit for piercing, while the weaker ones cause 
contused wounds, contusions, or abrased wounds. Thus it is very 
rare that perforating wounds are produced by large fragments of shell, 
the small fragments may well enter tissues, but owing to lack of force, 
mostly produce blind wounds and very rarely perforating ones. 



340 PERFORATED WOUXDS. 

Therefore, those which produce the perforating wounds are mostly of 
middle size ; on considering the examples before mentioned, we see 
that the wound with the smallest orifice was the size of the tip of the 
thumb, while wounds with large orifices are seen in the 2nd, 13th, 
17th, and 18th instances. Again, shell-fragments, for the same reason 
which makes them unfit for penetrating into tissues, receive much 
resistance from the air while flying through it, and in consequence 
remarkably soon lose their original velocity after flying a short dis- 
tance. This they do even sooner than the shells themselves, to say 
nothing of bullets. The relation that velocity bears to force is very 
great, for if a unit oi velocity be multiplied by two, the force increases 
to 4, and it by 3, the force will increase to 9, so a shell-fragment 
which has enormous force at the point of explosion will lose its force 
remarkably at a short distance. For this reason, the kinds of wounds 
inflicted, greatly depend on the distance of injured persons from the 
place of explosion. If the shell hurst near the man, either mutilating, 
lacerated, or perforating wounds will lie produced, hut if the explosion 
occurred at a short distance from the man. other kinds of wounds will 
be produced. Hence the cause of the rareness of perforating wounds 
may easily he seen. Now, the perforating wounds produced in the 
late war were chiefly caused by shell-fragments and numbered .'i:i oul 
of a total of 38 wounds, that is, 86.84 pel' rent of all perforating 
wounds, and the remaining ."> were inflicted by the following causes ; 
one by a shell its. 'It', one by a bullet and the other three by iron-pier, ■>. 
There is some suspicion that a wound ascribed to a shell itself as we 
have already said may have been produced by a shell-fragment, and 
one of the three eases ascribed to iron pieces may have been caused by 
a shell-fragment too. If so considered the ratio will he 92.1 1 percent. 
It is a natural result that iron-pieces produced only 2 or .'> wounds 



PERFORATED WOUNDS. 341 

and wooden-splinters none at all owing to the weakness of force. 

In perforating wounds, the entrance hole is. as a rule, larger than 
the exit. This can be proved in Nos. 2, 5. 8, 16, 17, 21, 22, and 25 
instances before mentioned. The entrance hole is larger than the exit. 
but as was already said, shell-fragments are unfit for penetration owing 
to their irregular shape and to the lack of velocity, and when they 
enter such places as the abdomen or thigh, the skin is not broken un- 
til it has been stretched to the utmost extent as is the case in produc- 
ing: a blind wound, ami for this very same reason, the orifices of the 
penetrating wounds may be more or less smaller than the shell-frag- 
ments themselves, in proportion to the degree of the yielding of the 
skin. However this can not be proved by fact, for there was no case 
of penetrating wound in which the shell-fragment was obtained so as 
to enable us to investigate the relation between the size of the wound 
orifice and that of the shell fragment. Indeed, in the 25th instance 
where the fragment remained in the skin, its size was ascertained, but 
as will be referred to later on, it was of no use for proving the fact 
concerned because there existed two shell-fragments which prevented 
us from identifying the one as the chief cause. The 22nd instance is, 
as will be related later on. the only case of more or less interest. At 
the moment of formation of the exit in the penetrating wound, as the 
shell fragment is already weakened in its force by piercing through the 
tissues, and the skin has nothing to support outside, it can greatly be 
stretched, the resulting orifice is not only remarkably small, but most- 
ly presents a simple fissure. The 2nd, 17th. and 22nd instances are 
those in which the entrance and exit holes have a great difference in 
size; and the entrance hole of the 2nd instance was no less than 15 cm. 
in diameter, and that of the 17th 12 cm. in length, was of course ow- 
ing 1 to the fact that the fragments were not small, but also in a certain 



342 PERFORATED WOUNDS. 

degree to the fact that they flew down in a slanting direction. 
Though the exits were strikingly small compared with the entrance 
orifices, they had an irregular square or a star-like shape, and nut a 
lacerated form. This was because the skin could not escape from 
losing substance in spite of its extension, as the shell-fragments were 
not small. On the contrary, there were cases in which both the en- 
trance and exit holes presented a lacerated form, as is seen in the 
10th and 23rd instances : this probably because the shell-fragment 
struck the part with their narrowest surface. If a shell-fragment is 
weak in force, it greatly depresses the skin producing a lacerated 
entrance hole, but the fragments in the said two instances certainly were 
not weak seeing that the bones were broken. Also, there were cases in 
which both entrance and exit holes bad almost the same size and shape 
as is seen in the 10th and loth instances. This was perhaps because 
in both cases the bone having been broken, the shell-fragments must 
have been driven out in a mass with the bony pieces as well as the 
severed soft tissues, so that the exit holes were made as large as 
the entrance ones. Indeed, incases of perforating wounds attended 
with fracture of bone, it is no wonder that the exit holes sometimes 
are larger than the entrance one, as it is a well known fact with the 
perforating wounds made by bullets involving the bone. This is ex- 
emplified in the 23rd instance in which the exit hole was larger than 
the entrance, probably owing to the fact that the broken pieces of the 
bone were driven out in a mass with the shell-fragment. But the 1st in- 
stance of the perforating wound is an exception to all reasons suggested: 
the wound was reported to have had an entrance hole i' cm. in diameter 
ami an exit hole somewhat larger and of a lacerated form ; and as it 
did not injure the hone passing from the hall of thumb to the hack 
of the hand, the size of the exit hole should have been smaller than 



PERFORATED WOUXDS. 34y 

that of the entrance hole; but .strangely enough it was somewhat 
larger. If the report was not erroneous, there is no other explanation, 
than to assume that the shell-fragment after entering the tissues, 
changed its flying axis and broke the skin at the exit with a larger 
surface than when it entered, or the shell-fragment was one with very 
strong force. When a conical bullet having a greater velocity produces 
a perforating wound, the entrance hole is generally round and some- 
what smaller in its diameter than that of the bullet, and the exit hole 
presenting a lacerated fissure is a little longer than the entrance hole. 
just as was seen in the entrance and exit holes of the 1st instance. 
Therefore, it is not strange that the same result should he produced 
by a shell-fragment having a great velocity. Only it is very rare that 
a shell-fragment has so great a velocity. 

Iii the 18th instance the inlet measured IN cm. long. 3 cm. 
wide, and 1.5 cm. deep, and the exit was of an irregular round form 
5 cm. in diameter. The existance of a long inlet resembled the 11th 
instance of penetrating wounds, where the shell-fragment must have 
struck the part parallel with its course, and so first produced a grooved 
wound; but the large size of the exit without injury to the scapula 
seems rather anomalous, and it makes us suspect that it may not have 
been the exit but the inlet. However, as will be seen from the blind 
wound received on the neck at the same moment, the shell-fragment 
of which came from the right side, it is certain that the man must have 
stood where he could receive the shell-fragment from this direction. 
The problem is still more inexplicable if we assume the above men- 
tioned grooved wound to have been the exit, for a shell-fragment pass- 
ing beneath the skin in a parallel line, would lie almost certainly un- 
able to pierce it in such a manner as to produce a Long grooved wound 
at its exit. 13 ut how are we to account for the exit being so large ? 



344 PERFORATED WOUNDS. 

Partly because the shell-fragment was not a small one, and yet it was 
certainly not very large seeing that it did nor injure the bone. There 
is, therefore, no alternative explanation except that the fragment, which 
was not weak in force, struck the sloping surface below the acromion 
process, and made its exit in a slanting line producing a comparative- 
ly large hole, as is usual with a blind or perforated wound caused by 
an oblique shell-fragment. There have been rases of perforated wounds 
with fracture where the exits are smaller than the inlets as in the Nth 
and 16th instances. This phenomenon is nor strange, if we consider 
that the fractured pieces of bone did not come our in a mass with the 
shell-fragment. Again, Xo. '2'2 was a ease in which the left elbow 
joint was perforated from the outer To the inner side, and at the same 
time .he left side of the chest in the 8th rib sustained a penetrating 
wound. Whether these two wounds were caused by one and the 
same shell-fragment can not be ascertained ; bur assuming that the 
arm was hanging at that moment over the side of the chest in its na- 
tural position, Ave may infer that a single fragment was the cause of 
both injuries from the correspoding situations of the wounds. If this 

was tin- fact, the case is a g 1 instance for showing that the for t' 

the shell-fragment differs when it produces a pei'forated wound and a 
penetrating one. and that such difference of force invokes a corres- 
ponding difference in the sizes of the inlets. The first perforated 
wound had an inlet of an irregular oval shape 6 cm. long. L6 cm. 
wide, and a lacerated exit of 2.7 cm, while the second penetrating 
wound had a gaping inlet of 3 cm. in Length attended with loss of 
substance. The large size of the first inlet had doubtless some connec- 
tion with the fact thai the shell-fragment pierced the skin obliquely, 
at a falling angle, hut seeing thai both 1 1 1> • exit of the first wound 
and the inlet of the second wound held the same angle with the inlet 



PERFORATED WOUNDS. 345 

of the first, the difference between the sizes of the first and second in- 
lets must be mainly attributed to the difference of striking powers. 
When the first inlet was made, the shell fragment had too much force 
to give the skin time to yield, accordingly a large hole was produced ; 
but when the exit was formed, not only was the force weakened, but, 
in addition, owing to the difficulty of finding a way out by breaking 
non-resistant skin obliquely, it allowed the skin to extend so as to pro- 
duce a comparatively small hole ; again, when the inlet on the chest- 
wall was made, the force was still further lessened and the skin 
stretched downwards and inwards at the 8th rib, till it broke at the 
10th rib. The inlet was therefore much smaller than that at the elbow, 
though much larger than the exit, but this was probably because when 
the wounds were made there was a difference in the tension of the skin. 
The 25th instance was a, case half-way between a perforated and a 
blind wound. In this case, though the shell-fragment thrust its point 
out through the skin, it could not entirely come out owing to entire loss 
of force. An object weak in force can not break the skin from with- 
in, for the latter offers an elastic resistance — that is, the skin has a 
remarkable yielding power which it is not easy for a weakened pro- 
jectile to perforate. As it often happens with blind wounds that shell- 
fragments stop under the skin, so there is no wonder that a spent 
fragment should remain after merely breaking the skin. The only 
thing strange in the present case is, that there were two shell-frag- 
ments in the exit wound. These two fragments were at first thought 
to have been originally a, single one, which being already partly 
cracked split into two on encountering the resistance of the tissues, 
when it penetrated the bod v. However, these pieces, when examined, 
were found not to coincide on any surface, so they must be regarded 
as distinct pieces which strangely enough struck one and the same 
spot and made a single wound. 



346 PERFORATED WOUNDS. 

The perforated wounds of the chest are the Nos. 3, 4, (i. 11 and 
26, occurring in 6 persons, each of whom was killed on the spot. 
The sizes of these wounds have not been ascertained, hut considering 
that as a rule a small shell-fragment can rarely inflict a perforated 
wound, we shall be able to imagine what the sizes were. Accordin" - 
to the experiences of former days when bullets of a larger calibre were 
used, perforated wounds of the chest, almost always terminated in 
death. It was therefore quite to he expected that the present six cases 
should all have resulted in instant death. 

The perforated wounds of the abdomen are six in number as 
shown in the 12th, 14th. loth. 19th, 23rd and 24th instances, all of 
which, except the 23rd, resulted in death. Two of them were cases 
in which the lumber vertebrae were crushed, and in another the injur- 
ed man was thrown overboard. The 23rd case died 8 hours after in- 
jury. Thus it will lie seen that perforated wounds of the abodomen 
have a very unfavorable prognosis. As already discussed under the 
heading of penetrating wounds, the abdomen is a part liable to penetra- 
ting wounds from large shell-fragments, leaving a comparatively small 
wound aperture. The sizes of the perforated wounds were mentioned 
only in instance Xo. 2o. but it can easily lie seen that the shell frag- 
ments producing them were not small : for a shell-fragment which 
produces a perforating wound is naturally stronger in force than that 
inflicting a penetrating one. Thus, in the case when a shell-fragment, 
not small, and having an irregular and rugged shape penetrates the 
abdominal cavity, not only are the visceraa injured, hut the vessels 
and nerves are also liable to lesion, and consequently instant death i- 
the natural result in most cases, owing to a severe shock or internal 
haemorrhage. The prognosis is incomparably more unfavorable than 
that ofhullct wound.-. Cases like No. 23 which in spite of the serious 



PERFORATED WOUXDS. 347 

wound, the injured man escaped instant death, without exhibiting any 
symptoms of shock, are to be looked upon as anomalous. This certainly 
depended on the circumstances of the visceral lesion, the direction of the 
shell-fragment; and also on the constitution of the injured man. Thus, 
it is hardly necessary to say that the result is not always the same in all 
cases. 

The only case of perforating wound of the head is the 20th instance, 
in which instant death was quite natural. The wounds of the head 
by shell-fragments, mostly take the form of mutilated wounds by the 
destruction of a part of the skull, or else of contused lacerated wounds 
attended with fracture or of penetrating wounds ; and it is very rare 
that a perforating wound is produced like in the present case. This was 
because the shape of the shell-fragment was not adapted for perforation. 

The 7 tli instance was a perforating wound of the neck resulting 
in death an hour after the injury. In this case, it is recorded that the 
carotid artery was not hurt, but neither the size of the wound nor the 
injury of the cervical vertebra 1 was recorded, hence we cannot affirm any- 
thing exactly, yet the rise of temperature after injury is very curious. 
It may have been due to a lesion in the upper part of the spinal cord. 

The 10th example was a case in which after the cure of a perfora- 
ting wound with fracture in the right arm, an incurable paralysis of 
the musculo-spiral nerve was left. From the position of the Avound 
which perforated the middle of the upper arm from back to front, it is 
probable that the nerve was injured at the same moment with the 
humerus, but perhaps, as the arm was kept with a splint, symptoms 
of nerve injury did not appear until some time after. We shall discuss 
this case more fully hereafter. 

(3) There were three perforating wounds caused by iron-pieces 
occurring in 3 persons, as follows: 



34S PERFORATED WOU.S'DS. 

1st instance : — A perforating wound of the soft tissues in the upper part of 
the left forearm, together with an abrased wound on the left leg, and burns on the 
face. The patient recovered in about 80 days. (No. 222.) 

2nd instance : — A perforating wound extending from the lower part of the spine 
of right scapula to the upper part of the right arm. The entrance wound at the 
scapular region presented a curved lacerated form, and the exit hole on the upper arm 
was a vertically lacerated wound 4.5 cm. in length with everted margins out of which 
the muscular substance protruded in a crater-like form. The scapula and the surgi- 
cal neck of the humerus were broken. "When the patient was admitted to the hospital, 
both the entrance and exit holes being enlarged, several pieces of the bone were ex- 
tracted. But at the time, the wound had already fallen into suppuration, and sloughs 
had been formed at the margin so that the development of granulation was unfavor- 
able. The case lingered on for about five months when erysipelas set in, and the 
patient succumbed. (No. 192.) 

3rd instance : — A perforating wound in the soft tissues of the right leg w T as 
received. The entrance orifice measured 5.5 cm. in length and 4.5 cm. in width, 
and the exit hole 3 cm. in length and 2.5 cm. in width. Though the bones, vess, ils, 
and nerves were not injured, the tissues around the wound were strikingly lacerated, 
consequently they sloughed and the wound was at last cured in three months. 
( No. 283.) 

There were only three perforating wounds caused by iron-pieces 
as above mentioned. This proportion to 60, the total number of 
wounds from the same cause, bears a ratio not larger than 5.00 per cent, 
which is The smallest percentage of all, for the contused wounds cover 
41.67 per cent, the blind wounds 20.00, the abrased wounds 16.67, 
contusions and mutilated wounds respectively 8.33. This shows 
thai iron-pieces, as already stated, are too weak to easily produce 
perforating wounds. Though iron-pieces are almost the same with 
shell-fragments in shape and weight, yel as the former are imparted 
with by far, the less velocity, they are consequently much weaker in 
force. At the time of battle, shell-fragments are scattei'ed aboul in a 
ship in a larger number and reach :i further distance than iron-pieces ; 



PERFORATED WOUXI'S. 349 

and naturally all kinds of wounds are caused more frequently by shell- 
fragments, especially this difference is markedly great in the case of 
perforating wounds ; for of all the wounds caused by shell-fragments, 
the perforating wounds have 11.45 per cent, while of all the wounds 
by iron-pieces the perforating wounds only cover 5.00 per cent, which 
is not half so great as the former. Now, if we compare the causes of 
perforating wounds at large, those caused by shell-fragments cover 86. 
84 per cent, and those pi-oduced by iron-pieces only 7.89 percent, 
showing 1 a great difference. 

The character of the perforating wound by an iron-piece was 
almost the same with that caused hv a shell-fragment. The fact that 
the entrance hole is larger than the exit was seen in the 3rd instance. 
We can not assert anything positively of the first instance, for the size 
of neither hole was recorded, hut there was perhaps the same difference 
with the 3rd instance, as both were perforating wounds of the soft 
parts. The 2nd instance was a very curious case as a perforating 
wound caused hv an iron-piece. Inferred from the recorded character 
of the entrance orifice, it seems that the iron-piece was a large rough 
fragment which first broke the skin with its curved flat surface ; and 
not with the pointed part which might have rent the skin with its 
sharp end. However, this piece smashei the scapula from the 
back, then entering the arm again broke die humerus, leaving a 
crater-like exit. The piece must have been an exceedingly forcible 
one, to do so much damage but it is doubtful how a scattered iron- 
piece could have lien imparted with so great a force, indeed, among 
various wounds inflicted by iron-pieces, there are such serious kinds 
as mutilated wounds, but tins is attributable to the ponderous size and 
weight of the pieces. However an iron-piece which may pro- 
duce a perforating wound must naturally he limited in size and 



350 PERFORATED WOUNDS. 

accordingly in weight. It' so. we must suppose that in producing 
so serious a perforating wound, the iron-piece was imparted with a 
striking velocity, which however is almost an unallowable supposition, 
as was seen from the instances of the contused, blind, and other 
wounds caused by the same kind of objects. That only three cases of 
perforating wounds were produced by iron-pieces goes to show the 
same fact. In two instances of the three under consideration, the iron- 
pieces perforated soft parts, so their effect was not at all anomalous 
considering that the pieces had a shape fitted for penetration, hut if 
the 2nd instance in cpuestion was really caused by an iron-piece, its 
force must have been exceptionally great. The injured person of the 
present case was reported to have received the wound in the Hivei at 
about 1.20 p.m.. when a hostile shell destroying the ship's side near 
No. 7 starboard gun, scattered iron and wooden pieces about. The 
shell itself w as reported to have passed off without explosion, and if 
this report be correct, the present case can not be attributable to any 
other cause than an iron-piece. However, before and after that 
moment, that is. at about 1.15 p.m. and 1.25 p.m. many shell-frag- 
ments w( - ittered in that ship, and besides, all the surgeons on 
board having been killed, the histories of the killed and wounded had 
mostly to be gathered from the memory of the survivors, and con- 
sequently errors may have been committed in recording the times 
the reception of injuries. 

(4) There was one case of perforating wound owing to bullet 
which is as follows : — 

1 I of the members of the lauding party at the Pescadores was shot from a 
distance of a few yards with a musket, and tlm la perforating wound from 

the chin to tli ide of the neck. The wound was lacerated 12 can. in length 

and 8 cm. in width. The bottom c immunicated with the cavity of the month ; the 
body of tl: v was broken tuto several pieces, and a part of it smashed 



PERFORATED WOUXDS. 351 

grains like sand and the miscles at tli 3 floor of tlia mouth were rent asunder. The 
carotid sheath was exposed though the vessels escaped injury. The facial artery was 
crashed ytt without haemorrhage ; articulations and deglutition were extremely dif- 
ficult. After a time, the tissues around the wound became sloughy; and several of 
tlie broken pieces of the bone were discharged. The wound was cured in five months, 
but owing to the imperfect articulations and deglutition, the man was discharged 
from service. (No. 105.) 

The wound in the above instance was a perforating one produced 
by a bullet, but being inflicted at a very short distance, accordingly 
its velocity or force being violent, the tissues of the wounded part 
were widely destroyed, so that the skin that will usually cover the 
wound canal was rent open producing a large gaping wound. This 
is an instance of the so-called explosive wound of bullet. When a 
part struck by a projectile having an extraordinary velocity, not only 
the pieces of broken bone but even the cells and liquids of the tissues 
being respectively imparted with a great momentum are prone to fly, 
therefore it is obvious that even a projectile so small as a bullet may 
sometimes do greal damage as in the present ease. 

As above mentioned, the total of perforating wounds was 38, and 
thev may be attributed to four different causes viz : — light machine 
gun shots, shell-fragments, iron pieces, and bullets. These 38 cases 
in proportion to a total of 629 cases of various wounds, bear no larger 
ratio than 6.04 per cent, showing the rareness of this class of wounds 
as compared with gun-shot wounds. This is the main difference be- 
tween them and bullet wounds, for perforating wounds occupy the 
largest number in the latter class of wounds. And the characters of 
the perforating wounds caused by shell-fragments and iron pieces 
differ greatly from that of bullets. The perforating wounds by the 
shell-fragments, not mentioning the large size of the wound canal, 
have comparatively larger entrance holes than that of exits, while 



352 LACERATED AND MUTILATED WOUNDS. 

with that of bullets, the difference is not so striking. Again in the 
perforating wounds caused l>y the shell-fragments, the tissues around 
the margin of the wounds are found greatly contused, and the skin 
around the entrance and exit holes is discoloured, while with those of 
bullets, such is not the case except in an instance of an explosive 
wound caused by bullets in short range. This is because the gun-shot 
wounds are caused by such objects as shell-fragments, or iron-pieces 
irregular in shape and unfit for penetration. The perforating gun- 
shot wounds have not only a large diameter, but damage the tissues 
around comparatively severely, so they generally result in instant 
death when they are indicted on vital parts as the chest or abdomen, to 
say nothing' of the head, and even on the limbs the character of the 
wounds is by far more unfavorable than those of bullets ; for in the 
former, the healing process is much prolonged, and during that time 
wound infections are apt to occur. Though the clinical history does 
not record it, there were some cases of perforating wounds from which 
pieces of cloth were washed out. When the parts covered with the 
dress were perforated, there is no doubt that the severed piece of cloth 
enters the wound in a mass with the shell-fragment, and it will be 
left within unless it adheres firmly to the fragment and is extracted 
with it. 

6.-LACERATED AND MUTILATED WOUNDS. 

The lacerated wound here considered, is strictly speaking that 
kind of injury in which the body is severed in two. or the head or the 
hand is entirely torn away, but those wounds in which though a greater 
pari of theehest or abdomen he lacerated, ye1 both the upper and 
lower halves of the bo.lv having good connection, should l>e culled the 
half lacerated woundB are included in this category. The mutilated 



L\CERATED AXD MUTILATED W0UXDS. 353 

wound is properly considered, that kind of wound in which either the 
body is rent to pieces and scattered, so that the personality can not be 
identified, or the body is so demolished that almost no trace of it is 
left, but it is not impossible that cases which were supposed to have 
sustained this kind of wound may actually have fallen overboard, at 
the moment of shell-explosions, and which nevertheless have been 
counted in this class. 

(A) The lacerated wounds were caused as fallow : — 

Hit by entire shell 10 cases. 

Hit by shell-fragments 27 ,, 

Hit by iron-pieces 5 ,, 

In the neighborhood of shell-explosions, causative 

objects uncertain 8 ,, 

Uncertain whether hit by shell-fragments, or iron- 
pieces 2 ,, 

By compression 1 ,, 

Total 53 ,, 

(1) The ten lacerated wounds produced by entire shells were 
one on the head, four on the abdomen and loins, one on the chest and 
abdomen, one on the left forearm, one on both thighs, and two on 
both legs. Of these, one of the head, one of the chest and abdomen, 
and three of the abdomen resulted in instant death. One person who 
had both legs and the forearm lacerated, (No. 289) and another person 
who had the abdominal walls lacerated (No. 175) having escaped in- 
stant death, were carried to the surgery on the upper deck, when a 
shell happened to explode on the deck below at the same time 
setting on lire a quantity of ammunition, they soon expired by the 
terrible shock thus caused. One who had his thighs lacerated, and 



354 LACERATED AND MUTILATED WOUXDS. 

one who had his legs crushed also escaped instant death but expired 
in ten minutes or more after the injury, and as these two persons alike 
received blind wounds from large iron-pieces on the thigh, they have 
already been mentioned in the instances given of blind wounds. 

(2) The twenty seven lacerated wounds produced by shell-frag- 
ments, were twelve on the head, six on the abdomen, one extending 
from the pelvic region to the right thigh, two on both thighs, one on 
the right thigh, one on the wrist, one on the right middle finger, and 
one on the neck extending to the lower jaw, and one each on the 
upper and lower Limbs of the same person. Twelve cases of the head, 
six of the abdomen, one of the neck, one of the thighs, one of the 
right thigh, one of the pelvic region extending to the right thigh, and 
one of the upper and lower limbs resulted in instant death. One case 
of the wrist was undergoing treatment in the surgery, when an 
enormous shell exploded in the room inflicting a large perforating 
wound on the upper part of the right thigh, and a burn covering the 
lower part of his body. The injured man died in ten days. (Xo. 261.) 
The only case which escaped death was the lacerated wound of the 
middle finger, accompanied with a blind wound of the left thigh. 
(Xo. 255.) 

(3) Out of five lacerated wounds produced by iron-pieces three 
were on the head, one on the right leg, and one on the right wrist. 
Of the three eases of the head which all resulted in instant death, one 

was caused by a, large fragment of gun-shield, another by a big frag- 
ment of funnel, and the third by a large fragmenl of gun-ban-el. 
One case of the right leg was produced by a big fragment of funnel, 
and accompanied with fractures of both arms, the injured man died in 
a few hours. (Xo. 291.) One case of the righl wrisl was also inflicted 
by a fragmenl of funnel and attended with a blind wound of the left 



LACERATED AND MUTILATED WOUNDS. 355 

leg, and contused wounds on the head and the left hand. This was 
cured in 3 months. (Xo. 230.) 

(4) Eight lacerated wounds produced in the neighborhood of 
the shell explosion occurred in six persons. Of these, two were on 
the abdomen, two on the chest, one on the chest and abdomen, two on 
both lower limbs, and one on the left thigh and the right leg, all 
of which were killed instantaneously. However, the case of lacerated 
wound of the chest and abdomen, first having 1 sustained a contused 
wound on the right lea - was undergoing operation in the surgery, 
when a shell exploded in the room and he was killed on the spot. (Xo. 
154.) The lacerated wounds now stated, are chiefly attributable to 
fragments of exploded shells, hut they may be regarded to have heen 
accompained with injuries by iron or wooden pieces or explosion gas, 
as these persons when wounded were stationed close by the place of 
shell explosion, where it may naturally he expected that various frag- 
ments of iron and wood would he driven about. In the clinical his- 
tory of these '"tses of instant death, only the chief wounds were record- 
ed to the exclusion of the smaller ones, and it was thought not proper 
to attribute them all to shell-fragments, so they have been classed 
under the head of wounds by the explosion of shells. The two wounds 
of the chest, and the two of the lower limbs both occurred in two per- 
sons, each sustained lacerated wounds in the chest and the lower limb. 
One of these occurred on the Matsushima, when an enormous shell of 
30.5 cm. exploded, and set on fire a large amount of ammunition 
(Xo. 152.). and the other on the Hiyei, when a hostile shell exploded 
against the stanchion near by, and set on tire the powder hag that he 
had hung on his breast. His chest was terribly lacerated, and at the 
same time the lower limbs were severed from his body, moreover his 
whole body was almost burned black. (Xo. 153.) All other cases 



356 LACEKATED A>'n MUTILATED WoTJXDS. 

occurred in the surgery of the Biyei when a hostile shell exploded 
there. 

(5) The lacerated wounds of uncertain cause whether produced 
hv shell-fragments or iron-pieces are two in number. One was caused 
bv the explosion of a shell against the gun-support, when shell and 
iron fragments inflicted the wound in the upper part of the right thigh 
and a penetrating wound on the head. He was killed instantaneously. 
The other was caused by the explosion of a shell against the gun- 
shield, when the left little finger was crushed, and at the same time he 
sustained a penetrating wound of the eye by an iron-piece, and a blind 
wound of the left leg. The injured man was invalided after the heal- 
ing of the wounds. (Xo. 111.) 

((!) One case of a lacerated wound by compression, was caused 
bv the compression of the right index and middle fingers between the 
gun-wheels while the man was engaged in tiring. He was invalided 
when cured. (Xo. 242.) 

< )f the 53 lacerated wounds above stated which occurred in 49 
persons, three cases of the crushed fingers, and one case of a crushed 
wrist were cured. One case of a crushed hand also sustained a large 
perforating wound and a burn on the righl thigh and died after a lew 
weeks. One case of lacerated wound of the riidit leg accompanied 
with a large contused wound with fracture of the upper arm died a 
lew hours after. Each case of lacerated wounds of both thighs, of 
both legs, ami forearms, and of the abdominal walls, though 

escaped instanl death, vet they expired a few minutes after being 
brought to the surgery. The remaining .">'.i persons were killed on 
the spot. A.s the Lacerated wounds are caused by such forcible and 

ponderous objects as shells, large shell-fragments, 0X' iron-pieces, they 

ire mostly fatal, except iii those of small portions of the distal ends of 



LACERATED AXD MUTILATED WOUNDS. 357 

the limbs, because the effect to the system by such injury is so terrible; 
indeed, hemorrhage was, as a rule, not so heavy, but the shock was 
found to be remarkable. The lacerated surface was in every case found 
rugged with soft tissues hanging like rags of uneven length, and 

CO O C C *— - ' 

usually with irregularly broken ends of bone. The condition of the 
lacerated wounds produced by such a forcible object as a shell, and that 
caused by a heavy object like a Luge iron-piece may be expected to 
differ from each other. However, owing- to the absence of concomit- 
ant observation of these wounds in one person, we are not in a position. 
from the respective reports concerning them to make any distinction. 
Among the lacerated wounds of the head caused by shell-fragments, 
there were many cases in which though the scalp was rent (without 
any remarkable loss to its substance), ami only a part of the upper 
half of the skull broken, vet the brain substance was so cleanly swept 
awav that no trace of it was left except the remnant of the torn 
membrane. This was perhaps because such a soft and comparatively 
mobile organ as the brain was smashed and scattered by the momen- 
tum imparted to it by the flying shell -fragments, ami this may sup- 
port the hydraulic theory held by some surgeons. Accordingly, even 
with a shell-fragment that is only large enough to produce a perforat- 
ing wound in other parts may sometimes prove exceedingly destructive 
when it strikes the head. 

(B) Mutilated wounds make a total of thirty cases, of which 27 
were those of the whole body, two of the lower half of the body, and 
one of the extremities; and 27 cases of them occurred in the Matsushima, 
two in the Hivei. and 1 in the Akitsushima. Among 1 the 27 cases of 
the Matsushima, -Mi were caused by the explosion of a single shell. 
The rest also were caused by shell-explosion. In the Matsushima, a 
30.5 cm. shell exploded striking the shield of the Xo. 4 side-gun, in 



358 LACERATED AND MUTILATED WOUNDS 

the fore part of the lower deck, and set on fire the ammunition stored 
in the neighbourhood. This event gave rise to so "Teat a havoc as to 
kill or wound one hundred persons at once, of which the entire bodies 
of twenty five persons were totally destroyed, and four limbs of one 
person were mutilated. Besides these, there were four cases of instant 
death. — One by the lacerated wounds of the lower limbs accompanied 
with burns over the whole body ; one by burns of the whole body ; 
one by the lacerated wounds of the le^'s and forearms, and one bv a 
lacerated wound of the abdominal walls — of these four, the last two 
cases were killed during treatment by the shock of the explosion. 
Thus, the total number of the killed amounted to thirty, and of the 
remaining; seventy wounded, twenty two died from extensive burns 
in the following periods ; — ten within twenty-four hours of the in- 
jury, five within forty-eight hours, three within seventy-two hours, 
two within a week, one within a fortnight and one within six weeks 
(the cause of death was due to the accompanying penetrating wpund 
of the abdomen). Such serious wounds having been produced at one 
time in the same ship, the condition was too dreadful to he described. 
Out of the thirty men killed on the spot, the stations of twenty-two 
of them could he ascertained as they were known to lie at their assign- 
ed posts, two, others were undergoing treatment in the surgery, and 
the body of one was found where he met his death. Hut of the rema- 
ining five — that is. two officers, one midshipman of the batteries, and 
two carriers of the wounded — it was impossible to discover in what 
pari of the ship death overtook them, for their duties obliged them to 
he constantly changing their stations, ami afterwards their bodies 
could not he found. Of the twenty-five persons \\ hose positions could 
In- known, two were killed by explosion Lias during treatment in the 
surgery, and one died from burns of the whole body and the positions 



Figure of explosion of 80.5 cm. shell in the 
fore-part of the lower deck of the Matsushirria. 



► Denotes the direction 

of the shell. 

* Denotes the exploded 

shell. 

• Denotes the position 
of killed men by mutilated 
or lacerated wounds. 

(a) Denotes the entrance 
of the magazine. 

(b.r.) Denotes the place 
where the ammunition 
was exploded and dam- 
aged the deck. 




LACERATED AXD MUTILATED WOUNDS. 359 

of the remaining twenty-two who died on the .spot are indicated with 
red dots on the accompanying figure — that is, three of the crew of Xo. 1 
gun ; one of Xo. 2 gun ; four of Xo. 3 gun ; three of the Xo. 4 gun ; 
one of the Xo. 5 gun; one of the Xo. 7 gun ; one of the Xo. 9 gun ; six 
men of the magazine party ; one of the torpedo-crew who was then assist- 
ing the magazine men, and one man in charge of the electric light, 
whose body was found near the magazine. As shown on the figure, 
a couple of 30.5 cm. shells came flying side by side, and one oblique- 
ly striking the barrel of Xo. 4 gun, bent it in this "/\" — shape and 
throwing it several feet away, it changed its course a little and passed 
off, svhile the other shell exploded striking the shield of the same gun 
and broke the shield to pieces, destroyed the windlass in the middle 
of the deck, and scattered a great quantity of shell-fragments and iron- 
pieces ; at the same time a great deal of ammunition exploded. (The 
amount of ammunition that was set on fire could not be ascertained, but 
according to the report of the Matsusbima, there seem to have been six 
12 cm. steel shells and iil ordinary shells, the quantity of powder in 
this ordinary shell was estimated at 9.751 Kilog. per cartridge). By 
tins explosion of the ammunition, the lower deck was rent, the upper 
deck bent, and a fire broke out. Those who were near the place of 
the explosion of the ammunition — the crew of Xos. 1 and 2 guns and 
especially those of Xos. ■"> and 4 guns and the magazine party — would 
naturally receive dreadful wounds by shell-fragments, iron-pieces and 
explosion-gas in fact their bodies were torn to atoms. But strangely 
enough, among the crew of Xos. 7 and 9 guns that were distant from 
the place of explosion, some were missing. It might have been ex- 
pected that lacerated wounds might have been produced at such a dis- 
tance ; but such serious injuries as to pulverize the body and limbs 
seem almost impossible, accordingly the circumstances at the time of 



3fi0 LACERATED AXD MUTILATED WOUNDS. 

the accident were inquired into and a survivor belonging to No. 9 gun, 
grave the following account : — 

The starboard battery of the lower desk (in the Matsushima), that is, where No. 
9 gnu was placed had ceased firing, as they hid received the order, "suspend firing" 
and the crew of the starboard battery were waiting their orders near their respective 
guns. I was then standing by the right side behind No. 9 gun about 2 yards off, 
when a tremendous sound that seemed to shake the whole ship to pieces arose some- 
where about the fore part of the port batteries, at the same time causing a terrific 
shaking of the ship. Until this time, no explosion smoke had been seen, but at 
the forepart of the starboard batteries, shell fragments and something like a mass of 
earth fell like a shower of rain or hail, and they were seen to strike the under surface 
of the upper deck and the ship's side, and I had scarcely said, " halloo," when some 
shell-fragments hit my head and face, at the same time something like a mass of earth 
struck my shoulders and chest. From the wound of the head, blond was running 
down. Then again, there arose a dreadful sound, when suddenly the batteries of the 
lower deck were entirely wrapped in flames, and at that moment, my body was thrown 
up by the explosion gas, and fell in front of the clothes shelves 2 yards off between 
the back of the battery and the gun room. The shock made me feel as if my breast 
walls had been broken, and I vainly tried to stand up, but I could not see a yard be- 
fore my face for flames and smoke, and felt as if I had been breathing hot ashes in the 
coalbunker. I now gave up all hope, and waited for death, hut finding my breath 
did not stop, tried to run out to the upper deck, and cam ■ to the second hatch which 
led from the back of No. 9 gun to the upper deck, that is, to the steps above the 
engine-room. I could not sou clearly, but there was a crowd crying and struggling 
to get up the gangway ; and so 1 was waiting for my turn, when flames again began 
to issue from the starboard entrance threatening to burn my hands, head, and face. 
I then hastend back to the first hatch in front of the battery, and trying to run out, 
came to where I thought No. 7 gnn stood. At this moment, I. was again buried in 
flames, and in an agony of suffocation, turned twice or thrice, staggered down, and 
again resigned myself to my fate with ; the words " 1 shall now die ! ". Our.' more I 
made up my mind to try my hardest to escape, and rushed towards the gun-port, 
which to my great joy I found to be that of No. 7 gun Thanking Eeaven that I bad 
escaped once more from the jaws of death, I mustered up all my courage, pulled my- 
self together, climbed out by the barrel, along the ship's side, and so got >u upon the 



LACERATED AXD MUTILATED WOUNDS. 361 

upper deck. There examining my wounds myself, I perceived that the two wounds 
on the head were very slight, and the chest which I thought had heen broken, was 
quite sound ; the left ear gave great pain, and had lost its hearing ; the inner sides of 
both legs — especially the right one — pained me as if they were broken ; but were only 
covered with black patches probably caused by the blows of cartridge fragments ; 
there was a little haemorrhage from the mouth and nose ; the hair of the head, eye 
brows, mustache, and hair on the back of hands was burned, but the skin was so slight- 
ly affected, that it could not be said to have sustained burns. I then set myself to ex- 
tinguishing the fire, together with Tokutaro Nagano who had made his escape by the 
same gun-port ; and afterwards, under the direction of Commander Mukoyama we set 
the things on board right, and posting ourselves at No. 9 gun, resumed firing. 

As regards the late seaman I. Sasaki, one of the members of No. 9 gun, there is 
no reason to assume that his body was blown to pieces while he was in the neighbour- 
hood of No. 9 gun. I was one of that gun crew and did my best to find his corpse. 
Some persons concluded that he had fallen into the sea while escaping by a gun-port; 
or been thrown overboard by the explosion gas. But I think otherwise. As third 
member to No. 9 gun, he was on duty as shell-carrier, and was going possibly to the 
elevator of the magazine in the fore part at the time of the disaster, and was thus 
blown to pieces by the explosion of the powder. The elevator, it is true, was in the 
neighborhood of the starboard batteries, but both deck and elevator were found terri- 
bly damaged and everything was quite as bad here as at the port batteries. Strange to 
siy, there were fourteen or fifteen cartridges, provided for No. 9 gun, but though the 
blanket covering them was blown away, not a single one exploded. 

It is certain that one of the bomb-shells burst, and its contents lay all over the 
clothes shelves : The fragments of the bottom of that shell were found behind No. 7 
gun, and between No. 7 and 9 guns was'fonnd a fragment of the bottom plate of a 
cartridge, which perhaps belonged to either No. 5 gun or No. 7. Of 40 gun-crews 
working at the lower deck batteries, only 4 persons, were able to continue working and 
my lucky escape was considered as a miracle by all. (Answer sent by seaman K. 
Miyata, member of No. 9 gun in the Matsuslihna). 

According to this report, the missing member of No. 9 gun was 
probably blown to pieces, or thrown into the sea, through a port-hole, 
happening to meet with the explosion as he came near the entrance of 



362 LACERATED AXD MUTILATED WOUXDS. 

the magazine, and another person that belonged to No. 7 gun seems 
to have met with the same fate, though we can not affirm it. positively 
in this ease, for there was another shell that exploded at No. 7 gun it- 
self. Besides these, some of the cases reported as mutilated wounds, 
may have been actually thrown into the sea through port-holes, etc. 

The mutilated wounds that occurred in the Hiyei were of two 
kinds: — those of the whole body, and those of the lower half of the 
body. In this ship, also, a 30.5 cm. shell knocked .through the wall 
of the captain's bedroom on the lower (leek, as shown in the accompany- 
ing cut, and entered the wardroom which had been turned into a sur- 
gery. The explosion broke the iron base of the mizzen mast. Every 
other thing 1 in the room — tables, chairs, surgical instruments, and I'm 1 - 

■ 

niture — was destroyed and scattered ; the room itself caught fire, and 

its walls were almost ruined. On examining surgical instruments 

O O 

that were afterwards picked up in various places, it was found that 
none of them retained their original shapes: — some were broken to 
pieces, and the others bent ; the probes doubled up, and strangest of 
all a sabre W;is found bent into a spiral. The Total number of the 
wounded and killed by this explosion was 40, of which 14 were killed 
on the spoT, 1 died during that da v. 1 after 4 days. 1 after 15 days, 
and 1 more after 17 days. The black dots in the accompanying cut 
show the Localities where they were killed or wounded on the lower 
'lec|<. All except the mutilated wounds have already been mentioned 
under the respective headings of wounds. However, in order that the 
effects given by a shell-explosion may he learned to better advantage, 
we shall again state the natures of the respective injuries received. 

1 he persons then in the wardroom where tin' explosion occurred were 

2 surgeons, 1 paymaster assisting them, ."> nurses. .". wounded perso 

1 carriers of the wounded, numbering 13 in all, and of these persons, 



Figure of explosion of 30.5 cm. shell in the lo\v< 
deck of the Hiyei. 




LACERATED AND MUTILATED W0UXDS. 363 

the black dot (5) received a mutilated wound of the abdomen ; (6) a 
perforating wound on the loins attended with fracture ; (7) a mutilat- 
ed wound of the lower-half of the body ; (8) partial mutilation of the 
chest and abdomen ; (11) mutilation of the whole body ; (1:2) a muti- 
lated wound of the abdomen ; (14) contused lacerated wounds, and 
burns on several parts of the body ; (15) mutilated wounds of the left 
thigh, and the right leg; (1(3) compound fracture of the face and the base 
of cranium. These 9 persons were all killed on the spot, and as already 
said, only the chief wound or wounds recognized as the cause of death 
being as a rule given, there must of course have been not a few cases 
which were actually attended with other wound or wounds. (9) 
Having sustained a lacerated wound of the hand, was placed on a large 
table used as an operating table and was receiving treatment, when he 
sustained a large perforating wound at the upper part of the right 
thigh accompanied with fracture, and a burn extending from the 
"'luteal region to the lower extremities. A few days later, he became 
delirious, and died in 15 days. (10) A person on the right side of the 
operating table was just going to apply a bandage to the wounded 
man. when he was thrown on to lower deck several feet oft", and 
sustained a dislocation of the right ankle joint and a fracture of the 
outer malleolus, accompanied with burns on the face and hand, and 
with the rupture of the tympanic membrane on each side. He was 
however able to return to service after recovery. (13) This was a case 
of compound fracture on the upper part of the right leg, with several 
other contused wounds on the head, face, and right thigh, and a large 
lacerated wound just above the left knee ; also, a burn covering the 
whole face. Further, though it was not stated in the clinical history. 
the membrana tympani on both sides were ruptured. Some time after, 
delirium set in and the injured person succumbed 4 days after. (17) 



3(34 LACERATED AND MUTILATED WOTJXDS. 

■ Burns on the head, neck, chest, and upper and lower extremities at- 
tended with the rupture of both memhrana tympani. The barns were 
healed and the hearing on both sides was gradually restored, but the 
person was dismissed as he became idiotic. The above mentioned 4 
eases were the only ones in the room at the time of the explosion, who 
escaped instant death ; and of these, two died later from traumatic de- 
lirium, 1 person became idiotic, and was dismissed from the service, 
and the last was the only one who was completely cured. Thus, of 
13 persons who were at the time in the room where the explosion oc- 
curred, 9 were killed on the spot, 2 died afterwards from their wounds, 
1 recovered but was discharged, and 1 only was able to resume service. 
No decided opinion can be given about the killed, their chief wounds 
only being recorded, but the t persons not killed on the spot all sus- 
tained burns, and three of them further sustained rupture of the 
memhrana tympani. Thus it can easily be seen that in eases of wounds 
inflicted in the very neighborhood ofa shell-explosion, there will occur, 
besides wounds given by the blow of powerful shell fragments, iron or 
wooden pieces, those injuries which are liable to be caused by explo- 
sion-gas and flames. Traumatic delirium ensued in 2 oul of the 4, 
showing a violent shock to the nervous system. This is agreeable to 
all experience elsewhere. 

[n the 4th quarter of the lower deck — that is. fore-part of the 
wardroom where the explosion occurred, there were 8 persons killed 
or wounded, of whom (IS) had both thighs mutilated and died on the 
spot ; (l ( j) met the same fate from the compound fractures of the face, 
the base of cranium and the upper and lower limbs; (20) sustaining 
compound fracture of the right thigh and heavy contused wounds oi 
the right arm and chest which killed him instantly : (21) go1 a blind 
wound in the left thigh, lacerated wound of the righl middle finger, 



LACERATED AND MUTILATED WOUXDS. 365 

contused wounds of the right index and ring fingers, and an abrased 

wound of the left leg. This person eventually recovei'ed ; but having 
lost the right middle finger, and the action of the index and ring fingers 
not being completely restored, he was dismissed after 45!) days of treat- 
ment; (22) received a grooved wound on the right forearm which was 
healed in 37 days; (23) an abrased wound of the seal]) which was 
cured in 3 days ; (24) a contused wound on the right thumb from a 
wooden splinter and recovered in 2 weeks; (25) a contused wound of 
the right thumb which was healed in 32 days. Thus 4 out of the 
8 persons, wdio happened to be very near the explosion and were most 
exposed to the shell-fragments, received mutilated wounds, or heavy 
lacerated wounds, which killed 3 of them; and 1. though not killed 
had to be dismissed after long treatment. The remaining 4 persons 
happened to he some little distance from the room where the explo- 
sion occurred, or to be on the starboard side of the ship, and were thus 
only slightly injured. No one in this 4th quarter received either burns 
or rupture of the membra na tympani, several persons indeed escaped 
injury altogether. 

In the 3rd quarter, only those persons who happened then to be 
at the entrance to the 4th quarter were injured, none of them being 
killed or succumbing to their wounds. Thus, (2(>) received blind 
wounds on the right arm and forearm attended with fracture, which 
healed completely after a treatment of 170 days; (27) a slight contu- 
sion on the right side of the chest which was cured in 3 days ; (28) a 
contused wound on the right temple which was healed in 23 days. Of 
these 3 persons, (2(!) sustained severer wounds than did (27) and (28) 
in the 4th quarter. This A\as probably because the shell-fragments 
came rlying direct, and their power had not been impaired. This was 
perhaps a matter of chance. 



30(5 LACERATED AND MUTILATED WOUNDS. 

In the cabin next to tin.- wardroom where the explosion occurred, 
4 persons were wounded by wooden splinters, and by the fire that 
broke out. Of these, (1) received compound fracture on the forehead, 
and burns on the face with haemorrhage in the left retina. He was dis- 
missed after a treatment of 140 days, as his eyesight did not return; 
(2) received an abrased wound on the lobe of the right ear which was 
healed in 4 days ; (3) compound fracture of tin- right fibula, ami :i 
contusion on the right forearm, both of which were cured in 38 day- ; 
(4) got a large wooden sphnter wedged into the left sacro-iliac joint, 
which caused paraplegia, and succumbed to the wound after 17 days. 
This (4) was the most serious c=ise of various wounds produced by 
wooden splinters. 

The above mentioned comprise the billed and wounded on the 
lower deck ; and besides these, there were l! persons killed or wounded 

in the neighborh 1 of the machine-gun magazine below the floor of 

the room in which the explosion took place, shell-fragments and other 
indirect shells flying down through the broken floor. 2 persons were 
killed on the spot, with mutilation of the heads, 1 person received a 
penetrating wound of the head died during the day : and the remain- 
ing ."> persons were all slightly wounded on the head, chest, and upper 
arm. Again, on the quarter-deck and bridge above the wardroom, 
there were ii persons wounded, of whom 3 got injured by being blown 
down on to the lower deck : and another was thrown down through 
the sky-light, and was burned by the tire. The remaining _ were 
injured by shell-fragments that Hew out of the sky-light, ami in the 
wound of one of them were found some husks of buck-wheat. [here 
were some others standing by the sky-light, whose clothes were torn 
to pieces b\ gas of the explosion. 



Bt"i;\s \XI> Si '\ LI'S. ;-j(j 



7.-BURNS AND SCALDS. 



a. 



(A) Most of the cases of burns occurred on board the Matsushim 
No fewer than 55 persons got burned at the time when the 30.5 c.i 
shell burst and set the ammunition on fire, besides 4 persons who were 
burned by the explosion of the shell. In the Hivei. 7 persons were 
injured owing to the explosion of the 30.5 e.m. shell ami fire ; 3 
persons each on the Itsukushima, Hashidate and Voshino by shell- 
explosion, and ."! persons on the Naniwa by flames from the discharge 
of their own guns. They number 78 persons in all. Of the 5!) 
persons burned on hoard the Matsushima, 25 were so seriously injured 
that they died, and of these persons. 1 died on the spot, entirely from 
burns ; in the case of 2 others the burns were attended with mutila- 
tion of the limbs, and lacerated wounds of the chest ; 18 died within 
.'! days before they had had time to be admitted to hospital, and 4 'lied 
in hospital. (Of the last 4. one 'lied owing to the penetrating wound 
of the abdomen.) Of the 3 nun on board the Itsukushima, 2 died on 
the spot owing to perforating wounds of the chest : and of the 7 on 
the Hiyei. 1 died 'in the spot from burns and contused wounds on 
several parts of the body, and of 2 others whose burns were ac- 
companied with serious contused wounds, one died before he was sent 
to hospital, and the other in hospital. Those, therefore, who were 
either killed on the spot and died afterwards numbered 30 in all; and 
of these 30, six were killed on the spot, (of these, however, only 1 
from pure burns, the rest died from serious accompanying wounds). 
Those who died afterwards were 24 in number, of whom 1G died 
purely from the effects of burns. Of these 24 persons, 4 died in the 
hospital, all the rest died before being admitted. Their burns were 
very extensive, not only exposed parts such as the face. neck, and 



.: :s ' BURNS AND SCALDS. 

hands being injured, but other parts also, from the burning of the 
clothes. In degree, the burns were mostly superficial, though in some 
parts, covered with clothes, it w:is otherwise. The burned surfaces were 
generally blackened by powder-fumes and unconsumed powder, and 
riie hair was much singed. In most of these cases, symptoms of 
shock were very pronounced, and the patients speedily collapsed. Ten 
of them died in the course of the day on which they were wounded. ."> 
"H the next day. and 4 on the 3rd day. Where there was a transition 
from the period of shock to that of reaction, the temperature rose in a 
remarkable manner, pain and thirst were intense, the patient became 
violent and traumatic delirium often ensued. The difficulty of treat- 
ing sii'-li a large number of patients was so great as to baffle descrip- 
tion: the surgeons and nurses were engaged in the task of dressing 
the wounds day and night without rest, and yet felt they still could 
not do all that was needed, and were therefore too busy to keep the 
clinical details of the cases. We can not therefore ascertain the record 
of cadi patient, but, in its general features we are told by the surgeons 
who witnessed the scene that the account above given is true. Patients 
of this class admitted to hospital numbered 43 in all. Of them 11 
were only slightly burned and admitted to hospital for other and more 
serious wounds. The remaining l)'2 persons entered hospital on 
;iccoun1 of burns alone, or of burns attended with other slighter 
wounds. With regard to these 32 patients, we have a report furnish- 
ed by Fleel Surgeon S. Tsuruda, who was engaged in the treatmenl 
of patients in the Sasebo Naval Hospital, and from this report we can 
form a genera] idea of tip- uses. A paragraph in the report says: — 

Burns.) Though the cases of the burns placed under the cave of the hospital 
differed much in burnt area, they were almost all the same in other respects, I need 
nol then fore record the particulars of each cms . but shall merely indicate the local i- 



BURNS A>"D SCALDS. • ;-},;, I 

ties of the burns and their terminations, and give their general appearances and 
symptoms. 

(1) Burns on the head, face, shoulders, upper extremities, left knee, and the 
middle of the left leg. Completely healed on December 21st, 1894. 

(2) Burns on the face, forearms and legs. Completely cured on December 
22nd, 1894. 

(3) Burns on the face, head, left upper arm, right forearm, back of the right 
hand, buttocks and the lower extremities. Died on September 23rd, 1894. 

(4) Burns on the face, back, abdomen, right upper extremity, left forearm and 
lower limbs. Died on September 23rd, the same year. 

(5) Burns on the face, neck, below the left forearm, outer side of the left thigh, 
leg and knee, dorsum of the left foot, autero-external part of the right thigh, and 
outer side of the right leg. Left the hospital convalescing on April 9th, 1895, and 
cicatricial contraction of the left fingers accruing, the patient again entered the hos- 
pital, and was discharged from service ou September oth, the same year. 

(6) Burns on the face, neck, below the forearms. Completely healed on October 
22nd, 1894. 

(7) Burns on the face and the upper limbs. Completely healed on October 
11th, the same year. 

(8) Burns on the face, below the middle of the left forearm, and on the right 
forearm. Completely recovered on October 12th, the same year. 

(9) Burns on the face, neck, below the right upper arm and left forearm, right 
gluteal region, and right thigh, attended with a subcutaneous perforating wound of 
the left leg. Owing to cicatrix of burns, free movements of the neck and upper ex- 
tremities were interfered with, consequently he was discharged from service on March 
16th, 1895. 

(10) Burns on the right upper limb, and gluteal region of the same side. 
Completely healed on October 11th, 1S94. 

(ID Burns on the face, both forearms, and right leg accompanied with sprain of 
the right ankle joint. Completely healed on December 15th, the same year. 

(12) Burns on the face, head, neck, below the middle of right upper arm, below 
the left elbow joint, left thigh, and right lower limb. Owing to cicatrices, the fingers 
of the right hand lost their movements, and accordingly the patient was dismissed on 
March 17th, 1895. 



370 BURN'S AX1> SCALDS. 

L3 I Burns on the face, neck, below, the lower part of the left upper arm, right 
forearm, back of right band, and botli legs, attended with lacerated wound of the upper 
arm, the patient left the hospital on February 21st, the same year, quite 
convalescent. 

1 14 i Barns on tbe bead, face, neck, rigbt side of the chest, back, right upper 
limb, left forearm, back of left hand, right lower limb below the right gluteal region, 
and left thigh. Died on September -20th, 1S94. 

(15) Burns on the face, below both forearms, attended with a perforating 
wound in the ball of the left thumb. After being transferred to the Kure Naval Hos- 
pital, be was completely cured on December Kith, the same year. 

16) Burns on the face, both forearms, and antero-external side of the left leg. 
Completely recovered on October 12tb. tbe same year. 

. 1 7 i Burns on the face, neck, and both forearms. Completely recovered on 

November 5th, the same year. 

(18) Burns on tbe face, head, nape, below left gluteal region, and right thigh, 
accompanied with compound fracture of the left index finger. The burns were heal- 
ed, but the left index finger having been Inst, he was discharged from service on 
March 16th, 1895 

(19) Burns on the head, face, back, both upper limbs and below both gluteal 
legions. On account of the imperfect movement of the limbs, the person was dismiss- 
i d from service on January 22nd, 1897. 

(20) Burns on the face, back, right upper arm, and both lower limbs. Com- 
pletely healed on November 11th, 1894. 

21) Burns on the face, chest, abdomen, and right upper extremity. Com- 
pletely cured on November 11th, the same year. 

(22) Bums on the back. Completely recovered on October 5th, the same year. 

(23) Burns on the face, back, and both upper limbs. Completely healed ou 
October 11th, 1894. 

(24) Burns of the face attended with contused wound of the left hypochondriac 
region. Perfectly n vered on October loth, the same year. 

25 Bun s of the head. face, right shoulder, lower parts of both upper arms, as 
well as oi both le.'s. The patient left the Ik spital convalescent on April 9th, 1895. 



BTJRXS AXD SCAT.! is. .;;] 

(26) Burns on the face, and below the lower ends of right forearm, attended 
with sprains of both ankle joints. The burns were healed, but owing to derangement 
in the ankle joints, he was discharged from service on June (3th, the same year. 

(27) Burns on the right leg accompanied with sprain of the right ankle joint. 
Perfectly recovered on December 30th, 1S94. 

(28) Burns on the head, face and both forearms accompanied with sprain of the 
right ankle joint, and rupture of both membrana tympani. After being transferred to 
the Knre Naval Hospital, the patient completely recovered on December 21st, 
the same year. 

(29) Burns on the face, left side of the chest, and left lower extremity, attended 
with rupture of both membrana tympani. After transfer to the Kure Naval Hospital, 
the patient recovered from his burns, lint owing to the perforation of membrana tym- 
pani, the hearing of either side was greatly impaired, and the man discharged from 
service on April 18th, 1895. 

(30) Burns on the face, nape and right forearm. After transfer to the Kure 
Naval Hospital, completely cured on November 5th, 1894. 

(311 Burns on tho lower part of right leg and on right foot. After transfer to 
the Kure Naval Hospital, completely recovered on October 24th, the same year. 

1 32 1 Burns on the face, both hands and both legs. Completely healed on 
October 16tl), the same year. 

Causes and localities (if burns Of the 32 patients above mentioned. 28 were in- 
jured on board the Matsushima, all by the explosion of gun-powder, 2 on the Yoshino, 
by the explosion of a hostile-shell, and the other 2 when the Hiyei was set on fire. 
The burns, as already indicated were mohtly in exposed parts such as the face and 
limbs, and rarely in places protected by clothes. This was perhaps because, the ex- 
plosion being instantaneous, the flames had not time enough to set the clothes on fire, 
and also because those who were severely wounded had all died before they were 
admitted to the hospital. The wounded are said, at the time of their injury, to have 
been wearing flannel shirts, under-drawers and Japanese socks. 

Area and depth of the burns. Accurate measurements were next to impossible, 
but speaking generally, in 3 cases (Nos. 3, 4, 14 above mentioned) the area of burns 
exceeded two thirds of the whole body : in one case the area exceeded one third of the 
whole body (No. lit) : in the remaining cases, the total areas were always less than 



37-2 BDRSS AKD SCALDS 

one-third of the whole body. The depths of the burns bore no comparison to the ex- 
tent of their areas, being mostly in the 1st or 2nd degree. However, in the ease of 
the above mentioned 4 patients, some of the burns were of the 3rd degree, and the 
right hand of patient No. 14 was sloughed all over. 

Appearances of the burned surfaces. The patients of the Matsushima were ad- 
mitted to the hospital on the 4th day after the battle, those of the Hiyei on the uth 
day. and those of the Yoshino on the 10th day. When first admitted, in the heavier 
e ises, the faces were blackened, the hair singed, and the heads and faces covered all 
over with yellowish black scabs : the eyes closed, the nostrils blocked, the ears swol- 
len, and the mouths unable to open easily. In the less severe cases, the faces were 
blackened and the eye-balls streaked, the limbs and trunks were in some parts only 
reddened, while in other parts there were blisters, the epidermis being abrased here 
and there ; the blisters presented various colours (gray or dark red) according to the 
nature of the matter accumulated in them. Parts where the epidermis had been 
abrased, and the true skin was exposed, were sometimes smooth and of a pinkish hue, 
at other times, granular and red ; in a few cases the parts had already sloughed : in 
short, the burns differed in appearauce according to their severity and locality. 

About a week after admission to the hospital, the dried scabs and destroyed epi- 
dermis had gradually come off, leaving the true skin exposed : — The blackened faci - 
of a few days before were gradually becoming pale, or pinkish, or absolutely white 
with scarlet dots (extravasation) here and there; and the ears, eyes, nostrils, and 
mouth were gradually opening. (No remarkable change had yet taken place in the 
looks of the less serious cases i. During the convalescent stage, the looks of the 
patients underwent a second change: — that is, the faces that had been pale at tie- 
period of suppuration gradually became light-brown, and then dark brown ; and those 
which had been flushed tinned by degrees to a dark red. It will be remembered that 
each of these had its own colour, according to the severity of the burn as 

w.ll as the constitution of the patient. In the limbs, in the more severe cases, 
there were left peculiar wavelike cicatrices bright and smooth, or keloid cicatrices 
dark red and ridged, while with slight cases only light brown cicatrices were left. 

t Beatrices and deformities. There were four cases in which remarkable cicatrices 
and deformities resulted. One (No. 5) losl the grasping power oi tb i left hind, owing 
to the cicatrix of the lingers ; one (No. 12) lost the larger part of both ear-lobes, and 
had all the lingers of the right hand stiffened, owing to the adhesion of the extensor 



BURNS AM) SCALDS. ;-;7:-S 

tendons of the Augers, this being caused by a deep cicatrix on the back of the hand ; 
aud one (No. 19) was deprived of the greater part of both ear-lobes, largo and con- 
spicuous cicatrices being loft <>n the upper ami lower limbs. Another ease (No. 9) 
resulted in a marked keloid cicatrix on each burned surface, so that the fingers became 
crooked, the neck bent, and the month distorted. The patient was pitiably disfigured. 

Complications of the burns. Traumatic delirium occurred in two patients, bron- 
chial catarrh in ."i or 6, inflammations of auditory canal and conjunctiva, existed in 
nearly all eases of burns on the head and face, though their exact number was uncer- 
tain, intestinal ulcerations and nephritis were unknown. 

Termination of the burns. With the patients who died in the hospital, the con- 
ditions before death were nearly always the same : — Temperature abruptly rising to 
39° or more ; thirst intense; pulse accelerated; spirits roused; delirium, cries, or 
singing ; withal, the mind firm without derangement in speaking, and answers correct. 
As death approached, the mind seemed to be as it were stunned, and the dying became 
mute, as in the ease of sudden death : no response was given either to call or irrita- 
tion ; heart action grew faint, pulse impalpable, inspirations being shallow, and 
expirations prolonged, and then first the heart ceased to beat, followed by cessation of 
breathing, and death ; thus change of symptoms was exceedingly rapid. 

There is indeed no wound that is not attended with pain, but no injury seems 
to be so intensely painful as a burn. Many of the patients cried and groaned 
throughout the night. When the time came for changing the dressings, the pain felt 
st cined to be so great that one could scarcely hear to see it. In one case the burned 
areas were so extensive that it required 3 or 4 hours to dress them all. It was a 
matter of great difficulty, even to dress the wounds bit by bit. One or two parts 
were dressed at a time, after which dressing materials were put on thickly, so that 
one dressing might last for as long as possible; but unfortunately it was the hot 
season, and there was always the danger of maggots being bred in the wounds if left 
too long without fresh dressing. Shell-wounds are cruel hut a burn is the most cruel 
wound of -all. We can not think of the scenes in the hospital without shuddering. 

(H) There were 8 cases of scalds, which were all caused by the 
.steam and boiling water in No. !' torpedo boat, when its boiler "was 
destroyed by a hostile shell. Of these 8 persons, 4 were killed on the 
spot, one died during the day, and one more on the next day, their 



374 UUPTUEB OF TYMPANIC MEMBRAXE. 

scalds extending nearly over the whole body. Of the two that 
recovered, one received scalds on the face, hands, and both legs, which 
healed in a little more than 80 days, while the other only sustained 
scalds ''ii the right leg and was well in a week. 

8- RUPTURE OF TYMPANIC MEMBRANE. 

Five persons thai were so injured, by the gas produced by the 
explosion of a shell close by. Of these ."> persons, •'> sustained rupture 
of membrana tympani in both ears, and one in one side only, both 
attended with burns of the face. The remaining one had the mem- 
brane of one side ruptured, and though he had not sustained any 
burn, his clothes were torn to pieces, evidently by forcible gas. Si- 
milar instances of clothes having been torn to pieces by explosion gas 
are found elsewhere : and there may perhaps have been many eases at- 
tended with rupture of the membrane among those who were killed on 
the spot, or died soon after from other wounds. There were 11 other 
cases caused by the vibration of air. and 1 case caused by explosion gas, 
both consequent on the firing of our own guns. Of these L2 persons, 
only ■') persons were injured in the membrana tympani on both sides. 



CHAPTER V 

i OM PLICATIONS OF WOUNDS. 

1— HEMORRHAGE. 

With the exception of contusion, we suppose that all wounds 
alike are attended at first with more or less haemorrhage. Ir is true 
that the haemorrhage and pain in the firsl stage are nothing more than 
the inevitable symptoms of wounds, hut for the s:ike of convenience, 
we will give them special headings. 

(1) Primary haemorrhage. In naval warfare, haeniorrage is com- 
paratively slight with every class and description of wounds. Every 
shell wound destroys tissues, and bruises more or less extensively the 
tissues of the surrounding parts; so whenever an injury is inflicted 
the vascular tissues sustain more or less contusion above and below. 
When the vessels are rent, their middle and inner coats are first turn, 
ami curled inwards : Then the outer coat hangs loosely down, so that 
the coagulation of blood in the vessels is greatly facilitated. More- 
over, with a mutilated or seriously lacerated wound, a severe shock 
will often occur which retards the function of the heart and still more 
facilitates coagulation. This is the reason why the haemorrhage is so 
small with shell-wounds. 

After the conclusion of the war. one hundred questions were 
drawn up relative to wounds and various sanitary matters, and an- 
swers were collected from surgeons. The following are the replies as 
far as they relate to the question of haemorrhage in shell-wounds : — 



376 HEMORRHAGE. 

Comparatively slight: Fleet Surgeon K. Yainamoto. 

Comparatively slight, except when large arteries of limbs are 

injured: Start' Surgeon S. Suzuki. 

No haemorrhage occurred from the facial artery in a case ot' 
com pound fracture of the lower jaw by a rifle bullet: 

Staff Surgeon V. Saito. 

Haemorrhage comparatively small, compared with incised or 
punctured .wounds : Fleet Surgeon S.Suzuki. 

Haemorrhage is not generally heavy enough to cause death, 

unless large vessels are injured : Staff Surgeon H. Fnjita. 

Haemorrhage slight : Surgeon K. Koyano. 

Haemorrhage recognised to be comparatively small : 

Staff Surgeon K. Maki. 

Ditto: Surgeon I. Yamashina. 

Comparatively small: Staff Surgeon M. Kusauo. 

Comparatively small, and not a case was observed in which 

blood spouted : Staff Surgeon K. Ogizawa. 

Arrest of haemorrhage was scarcely needed, but there was a 

danger of secondary haemorrhage: Staff Surgeon V. Amadera. 

Haemorrhage comparatively slight at the time of injury so that 
when the wounded men were brought te> the surgery, the 
haemorrhage was mostly found to have ceased of its own 
accord : perhaps because the wounds were either lacerated 
or contused, or because owing to shock, the action of the 
heart was weakened ; there was therefore almost no need of 
stopping haemorrhage : Surgeon S. Yamashita. 

Haemorrhage was very slight in every wound : ... Surgeon K. Moehizuki. 

Haemorrhage was comparatively small : Staff Surgeon If. Yamazaki. 

Haemorrhage was so very slight that not even dropping 
occurred: Staff Surgeon B. Seki. 

Haemorrhage from the wounds was comparatively slight, and 

tin' discovery of bleeding vessels proved difficult : 

Sin.' T. Slukano. 



HEMORRHAGE. 377 

Haemorrhage heavy when an incised wound was inflicted hy a 
powerful shell-fragment, but slight when a lacerated wound 
or such like was caused by a weak shell-fragment : 

Staff Surgeon K. Iki. 

Haemorrhage was recognised to be particularly slight in a 
lacerated wound caused by the fragment of a funnel, and 
when the patient was brought to the surgery, it was found to 
have almost ceased. Also small in every other wound : 

Surgeon T. Nakao. 

Though I had no opportunity of observing a case attended with 
injury of a large vessel, hemorrhage from the wounds was 
comparatively very little, just as in other lacerated wounds 
produced by the pressure of some blunt body : Fleet Surgeon S. Kimura. 

Haemorrhage was not heavy in shell-wounds as compared with 
other injuries, for in the former the tissues are either 
destroyed, lacerated or mutilated : Staff Surgeon B. Tomatsuri. 

With the mutilated wounds of both thighs and both legs, 
haemorrhage was found to be very copious, but in other kinds 
of wounds comparatively slight : Satff Surgeon T. Murakami. 

Comparatively small in quantity : Surgeon S. Negoro. 

I observed a case in which the lower jaw was smashed and the 
facial artery was rent, almost without the loss of a drop of 
blood: Surgeon K. Toyama. 

I did not notice any case of spouting haemorrhage; the bleeding 
mostly stopped of its own accord, and what hemorrhage 
there was, of an oozing nature as the dressings were found 
wet a few hours afterwards : Surgeon K. Usui. 

I observed a case of mutilated shell-wound at the lower part of 

the forearm attended with burns, and another case of 

lacerated wound of the forearm, attended with fracture of 

the ulna and injury of the artery, and found haemorrhage 

very slight in the former case and heavy in the latter : 

Surgeon N. Takenonchi. 



378 HiEMOEBHAGE. 

Haemorrhage was so slight that it had stopped when the wound- 
ed men were brought to the surgery, and there only a slight 
haemorrhage took place when the wounds were explored: 

Surgeon K. Asano. 

Haemorrhage was not heavy : Surgeon Y. Fu'ii. 

On the Hiyei, I examined a case in which l(i hours had elaps- 
ed since the injury. The haemorrhage was wonderfully 
slight — so slight that it hardly deserved the nam.'. In some 
cases attended with fracture, the haemorrhage was heavy 
owing to bleeding from the marrow. I can say nothing 
about the more serious cases, as I did not see them until 
death had taken place : Surgeon K. Yoshimura. 

There were many cases in which haemorrhage tool; place at 
the moment of injury, but ceased almost immediately : 

Surgeon K. Tawara. 

Haemorrhage was very slight, probably owing to blood coagula- 
tion consequent on the laceration of vessels. For instance, 
when amputation was performed in the ease where the wrist 
was mutilated, and the hand hung on to the wrist by a single 
piece of skin on the ulnar side (No. 201), a coagulated column 
of blood was extracted from the radial as well as the ulnar 
artery which measured several inches long : Surgeon K. Asai. 

Haemorrhage was, as a rule, recognised to be slight : Surgeon T. Kagami. 

Thus, the observations of nil the surgeons coincide in showing that 
haemorrhage was slight. These observations are of course of a general 
nature and do not hold good for all cases, for as is seen in the clinical 
histories of the second chapter, there are some cases recorded which 
were attended with heavy haemorrhage. I his depends greatly on the 

injury to the hi 1 vessels ; — when they are rent asunder, coagulation 

is rapid, as already shown, and accordingly haemorrhage is slight ; hut 
when they are only perforated or half rent, the middle and inner coats 
of the vessels being hindered from curling up, coagulation does not 



HEMORRHAGE. 379 

take place, and consequently haemorrhage will be heavy, as is well 
known. Shell-fragments and iron-pieces are irregular in form, and 
have sharp angles and keen edges. They not unfrequently give par- 
tial laceration to the blood vessels, besides complete laceration of them 
as in the mutilated wounds, consequently haemorrhage will be severe 
in such cases. Strange to say some cases are recorded in the clinical 
history of heavy haemoi'rhage of those killed by mutilated wounds; 
but this was not always from personal observation of the surgeons, 
who not being eye-witnesses depended on the reports of others, and 
consequently it is difficult to ascertain positively the real amount of 
haemorrhage. But in the cases Nos. 264 and 290 clinical history 
of mutilated wounds of both thighs and of both legs, which occurred 
in the Tsukushi, haemorrhage was observed to have been copious by 
the surgeons themselves. The arteries of the thigh are too large even 
though torn asunder to form enough coagulation as to immediately 
stop haemorrhage, therefore if not attended with shock, haemorrhage 
may continue to the moment of death, and even if arrested at mice, the 
loss of blood will still lie very great. The blood-vessels of the leg also 
are not small, so the loss of blood was probably great. These two 
cases were caused by the impact of an entire shell of great velocity, and 
the difference in its effect from that of a. wound by a shell-fragment, 
is much the same as the difference in being wounded by a sharp sword 
to being cut with a blunt blade, this probably accounts for the heaviness 
of the haemorrhage. At any rate, it is certain that haemorrage did not 
last long, for shock was heavy in both cases and the injured persons 
died in a few minutes. Another instance (Xo. 291 clinical history) 
occurred in the Fuso : a case of a mutilated wound of the middle of 
the right lei; - by a fragment of funnel, and of a compound fracture on 
the right ami the left arm. The clinical history states that in this 



380 HEMORRHAGE. 

case haemorrhage was copious in each wound, the fare turning pale, 
pulse thready and intermittent, and the patient almost instantly fall- 
ing into unconsciousness. This is <pute natural, because the tissues 
having been roughly destroyed by a weighty iron-fragment a severe 
shock took place ; haemorrage ought to have been very slight, and it 
seems rather strange that the contrary is recorded. But iron-pieces 
and shell-fragments do not always have the same effects, some of them 

O ml 

having keen edges may happen to sever or half sever a blond vessel, in 
which case heavy haemorrhage may occur from such a wound. But 
this reason ran nor be put forward in this case and if it is true as 
recorded, that haemorrhage was heavy from each wound, then it must 
be put down to the peculiar constitution of the injured person, and the 
unconsciousness accordingly attributed to the heavy haemorrhage. 

As regards shell wounds, it is very rare that the injury of a 
blood vessel is the sole cause of death, for instance, according to the 
clinical history, No. 15-i received a deep contused wound on the inner 
side of the lower third of the right thigh, by which the femoral artery 
having been injured, haemorrhage took place, the bleeding however 
being at once staunched by the application of a compress by a carrier, 
the patient was brought to the surgery and receiving treatment, when 
the explosion of a shell, mutilated his chest and abdomen and caused 
instant death. This is an instance of an injured artery where 
haemorrhage does not seem to have been heavy, he might have recover- 
ed if he had not been subsequently struck with the explosion of the 
shell. Among the killed by the penetrating wounds of the abdomen, 
then- are one or two eases in which the cause of death appears to have 
been haemorrhage owing to the injury of large blood vessels in the 
abdomen. But this is merely supposition, and not proved by autopsy, 
for such a severe wound of the abdomen may produce death independ- 



HEMORRHAGE. 38] 

etit of haemorrhage. Besides these, there are only two other instances 
in which haemorrhage .seems to have been the cause of death : — that 
is ; Xo. 127 clinical history, of which the only record is that a shell- 
fragment penetrating the front of the neck, pierced the trachea and 
oesophagus injuring the right carotid artery and caused instant death 
owing 1 to heavy haemorrhage. The statement is too brief to learn from 
it the size of the wound orifice, and whether the cervical vertebrae were 
injured or not, etc. But judging only from the report, we think the 
perforation of the trachea and oesophagus is in irsclf serious enough to 
prove fatal sooner or later ; but hail it not been for the injury of the 
right carotid, probably instant death would not have supervened, but 
the heavy haemorrhage must have had much to do with accelerating 
it. Also as the injury of the carotid artery is liable to involve the 
vagus nerve, this may also have assisted in causing death. The other 
is a patient of Xo. 143 clinical history, who died from haemorrhage, 
lie received a penetrating wound on the Left side of the chest break- 
ing the 5th and (3th ribs, and owing to copious bleeding haemothorax 
was produced to which the patient succumbed on the next morning. 
I his vvound was attended with a blind wound on the lower limb which 
however was not serious. As was already discussed in the foregoing 
chapter, it seems the shell-fragment did not enter the thoracic cavity, 
hut cnme out after breaking the ribs, and the rupture of the intercostal 
arteries was indirectly caused l>v the smashed pieces of the ribs. 
Again, admitting that the shell fragment pierced the thorax, it must 
he considered merely to have fallen in the cavity, as there existed no 
symptoms of lung injury. Therefore, the wound by itself was not 
serious enough to cause speedy death, hut haemorrhage was the real 
cause. So, if the injured vessels had been ligatured, his life might 
have been saved. It is much to he regretted that at the time ir was 



382 HEMORRHAGE. 

impossible to do so (further reference to this will be made in the next 
chapter.) In shell wounds of all other parts, when blood vessels 
smaller than middle sized are injured, haemorrhage is not heavy, and 
it will almost always stop of its own accord, if dressings are applied. 
Bui in eases of injury of the intercostal vessels, the pressure given by 
the application of dressings does no1 reach the vessels, and the blood 
coming out of these arteries flows into the pleural cavity, and does not 
have such a favorable effect in procuring the coagulation of blood as 
is the case with the haemorrhage of other blood vessels, in which the 
blood coagulating 1 by degrees in the tissues and increasing 1 the internal 
pressure of tissues, favors further coagulation. Accordingly, haemor- 
rhage may naturally last till the time of death, and in such cases it is 
ueedless to say that timely ligature of the injured vessels is of the ut- 
most importance. 

(2) Secondary haemorrage. It has been argued that with shell 
wounds produced by any cause, the tissues are destroyed, the marginal 
tissues contused, so that sloughing layers are most liable to be produc- 
ed at the edges. When the sloughs come off the blood vessels ha\ ing 
also sustained contusion, haemorrhage may probably set in, even 
though it did not takeplace at first. But strangely enough, in the late 
war there occurred almost no secondary haemorrhage. The only case 
in which any secondary haemorrhage may be said to have taken place 
in the patients admitted, is the case of No. '2'2ij. During his sleep at 
night, haemorrhage occurred from the small wound on the temple, 
which was rather profuse in quantity, but owing to prompt ligature 
oi the vessels, it was directly staunched, before anything serious had 
occurred. This was the only case of secondary haemorrhage among 
the patients in the hospital, and the interval between the reception 
oi injury and admission being mostly 3 or 1 days, none probably 



XERVOUS SYMPTOMS. 333 

happened before the patients were placed in the hospital, neither does 
the clinical history remark on any such cas . 

2.-NERV0US SYMPTOMS. 

(1) Shock : In the shell wound produced by any cause, tissues 
are roughly crushed by an object unfavorable to penetration, and there- 
fore considered theoretically, shock should very often occur. However-. 
on this point, the observations of the surgeons do nor agree as will be 
seen from the following answers on this subject as one of a hundred 
questions set To them. 

Symptoms of concussion were noticed in most serious cases : 

Staff Surgeon S. Suzuki. 
I'd ims of concussion were very slight, perhaps owing to the 
mental excitement of the injured men : Fleet Surgeon S. Suzuki. 

I did not observe any case in which symptoms of concussion 

existed: Staff Surgeon K. Maid. 

None of the wounded men presented symptoms of concussion : 

Surgeon I. Yamashina. 

There were many cases in which serious symptoms of concus- 
sion occurred: Staff Surgeon K. Ogizawa. 

Comparatively rare : Staff Surgeon Y. Amadera. 

During the battle, the minds of the combatants were so ex- 
tremely excited that even among the seriously wounded, 
some of them did not forget their dutv, and although their 
fiices became pale and pulse weak, they retained their 
equanimity, and it was not until the fight was over, that 
their vitality was abated and showed symptoms of con- 
cussion : Surgeon K. Mochiznki. 

Concussions were comparatively severe : Staff Surgeon H. Yamazaki. 

There was almost no case attended with concussion : 

Surgeon S. Yamashita. 



384 NERVOUS SYMPTOMS. 

Even in cases of mutilated wounds, I did not observi symptoms 
of concussion : Surgeon T. Nalcao. 

As a rule, symptoms of concussion were heavy, but there was 
a case of :i large perforating wound of the abdomen not 

attended with concussion at all : Fleet Surgeon S. Kimura. 

I observed severe shock in two patients with mutilated 
wounds of the lower limbs; especially so with the patient 
who had both his thighs mutilated : Staff Surgeon T. Murakami. 

Concussions were comparatively severe : Surgeon S. Negoro. 

During the battle, as the mind was excited there were some 
who, though wounded yet feeling no great pain, stuck to 
their post, but others though not heavily wounded, yet, pre- 
sented symptoms of concussion. This was the case, firstly 
with the patient who was inflicted with a blind wound on the 
chest wall with a fragment of shell retained between the 
ribs; secondly with another who sustained a contused 
wound in front of the chest; and thirdly with one who receiv- 
ed a contused wound on the front part of the elbow, which 
joint however was safe. In these 3 cases tin- symptoms 
were rather serious. These were abstainers and of quiet 
character: Surgeon K. Usui. 

Observing two patients of contused wounds attended with 
fracture of the upper limb. I found that concussion was not 
marked: Surgeon N. Takeuouchi. 

I observed concussion in a patient who sustained a perforating 
wound of the thigh accompanied with a contusion of the 
chest, and haemoptysis occurred. In about 15 minutes re- 
action set in. In any other case, I did not notice signs of 
concussion: Surgeon K. Asauo 

There were very many cas !S attended with concussion in the 

wounded ( f the If iyei : Surgeon K. Yoshimnra. 

Though I did not observe any constitutional signs of concus- 
sion, I found local concussion to he marked : Stall' Surgeon T. Xakashima. 

Concussions were comparatively heavy : Surgeon K. Kagami. 



NERVOUS SYMPTOMS. 385 

I saw no concussion occurring from the wounds of shell-frag- 
ment, bnt saw it in a patient who sustained a contused wound 
by a wooden splinter : Surgeon K. Tawara. 

We see therefore that concussion and its degree not only depends 
on the character and position of the wound, bul also on the constitu- 
tion of each individual and his condition at the time of injury ; which 
accounts for the surgeons on the various ships not agreeing in their 
observations. With regard to the characters of wounds, those produc- 
ed in the naval battles would naturally be more subject to concussion 
than those occurring elsewhere. Especially, wounds on the head, chest, 
and abdomen are susceptible to shock, and even those of the limbs when 
the wounds are of a mutilated kind. However, this does not always 
hold good, because the condition of the wounded person at the time of 
injury has much to do with it. It has long been proved that the 
mind of combatants being excited at the time of fighting, thei-e are 
cases in which in spite of fatal wounds, concussion docs not occur. 
In our late war also, there were not a few persons who received large 
perforating wounds of the abdomen, or mutilated wounds of the limbs; 
but they did not show any signs of shock until death supervened. 
But those persons who were in the neighbourhood of the explo- 
sion of shell, no matter the causative objects or the size of the 
wound, were often attended by concussion, as the body received sucb 
a shock as to paralyze the nervous system. This accounts for many 
more instances of concussion observed by the surgeons on hoard the 
Matsushinia and Iliyei. Besides, in the Matsushima numerous cases 
of extensive burns occurred which as is well known occasions serious 
shock. In addition to this in the various ships many fainted at the 
time of injury, as is shown by Nos. 132, 138, 139, 203, 211. 291, 
324, etc., in the clinical history, which were all less serious cases. 



;-)-,(•> XERVOUS SYMPTOMS. 

This depends greatly on the character and position of the wound, and 
the condition of the wounded person al the time of disaster. Now in 
the late war. concussion was recognised to be comparatively frequent 
in the contused wound or contusion of the chest : especially in the 
wounds caused by the blow of an object unfavourable for penetration 
such as a wooden splinter : and also in the wounds produced at the 
same time with the shock of explosion. If is true that this depends 
on the constitution of each individual, but it has not necessarily any 
relation with his timidity or courage as is widely known. 

(2) Traumatic delirium. In the Matsushima and Hiyei, this 
symptom was seen among those who were wounded in the neibour- 
hood of the places where enormous shells had exploded, but in no other 
case. Iu Matsushima these were all cases of hums, of whom 2 or •"'> 
died before they were admitted to the hospital, and 2 died in the 
hospital. 1'ach was burned extensively over the body. There were, 
also many patients suffering from burns in the hospital, in whom 
uervous symptoms, more or less irritating, manifested themselves. 
Unable to sleep well at night for pains, they lay groaning, crying, or 
singing aloud, but as the mind remained clear, it could no1 be said 
that they were delirious. Two patients were affected with delirium on 
the Hiyei: — one had sustained lai'Li'c contused wounds on the head, and 
lower limbs, attended with burns on the face; the other had first receiv- 
ed a mutilated wound of the hand, and afterwards a large perforating 
wound of the thigh, and burns. The one died 1 days after injury, 
and the other Lo days. These cases vvere probably, partly owing to 
the disturbance of the nervous system by the shock of explosion, and 
partly owing to the exhaustion of the nervous system occasioned by 
sleeplessness consequent on pain. 

(.')) Paralytic insanity consequent on the lesion of the cortical 



NERVOUS SYMPTOMS .;-7 

substance of the brain accompanying contused wound of the scalp. 
There were two cases : one was No. 9 example of contused wound by 
shell-fragment, and the other No. 1 example of contused wound by a 
wooden splinter. In each case, as we have already considered, the 
compression of the sensory and motor centres near the fissure of 
Rolando seemed to be the cause. The precise character of the lesion 
could not, however, be ascertained, for not only could no injury be 
recognised on the skull, but the patient afterwards completely recover- 
ed. (See examples of the wounds in the preceding chapter.) 

(4) Injury of nerves. With shell-wounds, a nerve may sustain 
contusion, or may be partly or entirely severed; but it also frequently 
happens that a large branch will escape injury on account of a favour- 
ed position or stout sheath. This is especially the case when the man 
is hit by an obtuse headed missile like a bullet. In this war. there were 
only 2 cases in which rather a large nerve was plainly injured by a 
shell- fragment or piece of iron or wood. One is No. 7 instance of 
contused wound by an iron piece in the last chapter, in which a 
contused wound sustained just above the internal condyloid eminence 
of the right humerus. At first, there seemed to be no lesion in the 
ulnar nerve, but paralysis accruing in the distributing region, the 
nerve must have suffered a contused wound by being compressed 
between the iron-piece and the bone. The paralysis lingered on after 
the wound had healed, but disappeared ultimately. The other case 
is Xo. 10 instance of a perforating wound by shell-fragment in which 
the middle of the humerus was perforated from back to front. A\ hile 
the splint was being applied, no paralysis was recognised in the limb, 
but when afterwards the splint was removed, paralysis was found in 
the region supplied by the musculo-spiral nerve, and this was never 
completely cured. We could not ascertain the character of the wound, 



388 SUPPURATION. 

that is. whether the nerve was contused or lacerated lmt inferring 
from the position of the wound orifice, it is beyond doubt that at any 
rate the nerve was injured by a shell-fragment, and we believe that 
this is not one of the eases very rarely met with in which, owing to 
irregular development of callus, a nerve is compressed so as to suffer 
functional derangement. Therefore, with wound sustained in parts 
having a trunk of nerve, it is important that the inside of the wound 
should be at once examined, in order to ascertain whether the nerve is 
safe or not ; and if it be found lacerated such measures as nerve sutur- 
ing should be taken before the nerve undergoes degeneration. 

3. SUPPURATION. 

In the case of patients so heavily injured in the engagement of 

the Yellow sea. as to need hospital treatment at home, the wounds were 
almost all found suppurating when received into the hospital. Ample 
provisions had been made before the commencement of the Avar to pre- 
vent suppuration by strid attention to antiseptic measures. The re- 
sult was therefore quite contrary to our expectation, but much though 
we regret it. it could not In- helped under the circumstances at thai 
time. 

Shell wounds are frequently heavy, and always of a lacerated na- 
ture, so thai tissues around the wound usually sustain serious contu- 
sion : the tissues of the afflicted surface lose their vitality, and with it 
their power to resist micro-organism, and thus even a few micrococci 
multiply at once and bring on suppuration. This is a fact long as- 
certained hv experience. Moreover, the tissues around the wound are 
torn irregularly, so that ext remely irregular cavities being thus formed, 
which i, nee invaded bv micro-organism, cannot easilv be sterilized. 



SUPPUKATION. 389 

Hence, in order to prevent a shell-wound from suppurating, ordinary 
antiseptic measures are of no avail ; strict precautions must be taken 
under careful management. The usual method of disinfection nowa- 
days is, before an operation, first, to cleanse the skin of the part with 
soap and warm water, next to rub with a brush, and then to ir- 
rigate an antiseptic solution like carbolic acid, followed by a cover of 
cloth dipped in the same solution. If the disinfection of instruments 
&c., be also perfectly effected, the operation will mostly prove success- 
ful without any fear of suppuration. It has been however proved by 
experiments, that if a superficial layer of the disinfected skin, be sliced 
off for an experimental cultivation, the growth of micro-organism will 
generally be observed. Tin's shows that there still lie some micro- 
organism concealed in the skin after the usual disinfection, which may 
sometimes find their way to the operated surface. Hut in a case like 
this, the tissues of the wound surface are destroyed only to a thin mi- 
croscopical depth, whilst the surrounding tissues are healthy and re- 
tain their strength of resistance, and the micro-organisms entering 
that part are very few in number, therefore the multiplication of micro- 
organism is prevented and the first union is generally successful. 1 Wit 
though such antiseptic measures may prove effective with usual wounds, 
with shell-wounds they can not Le said tube perfect ; for when invad- 
ed by pus cocci hidden in the skin, however few they be, the surround- 
ing tissues which have lost their resisting power, are very Liable t 
suppurate. This is one of the causes that make shell-wounds suppu- 
rate more frequently. Again, it is a very difficult matter to obtain a 
suitable surgery in every ship, and temporary surgeries in the ward- 
room or the gun room, are often extremely inadequate viewed from an 
antiseptic point of view. Moreover during a battle, the scuttles are 
mostly closed up, and light and air excluded ; the firing of guns keep 



o 



390 StTPPTTRATIOX. 

the ships in agitation; and every thing is tilled with the dust and dirt 
of an engagement. Amidst such conditions, it was almost impossible 
to preserve the wounded surfaces from being soiled. 

The clinical history does not record many wounds in which ;i 
piece or pieces of cloth remained within. But considering' the shape 
of the objects causing shell-wounds, it seems very likely that a piece 
of cloth or some torn fibres should be carried into the wounds, not 
only in blind wounds, but in perforating or contused wounds, in parts 
covered with clothes ; and if such a piece be carried deep into a wound. 
its surface being - very irreguhir, removal of the piece is extremely diffi- 
cult. This becomes another cause of the wound being liable to con- 
tamination. The circumstances of the time and the nature of the 
wounds combined to make suppuration easy : and a wound once sup- 
purated is very difficult to stop. Moreover in most ships, with a few 
exceptions, two surgeries were provided one fore and one aft ; each 
surgery had only one surgeon assisted by one or two nurses, ami when 
wounded persons were carried in. one after another, no proper treat- 
ment could lie given owing to the insufficiency of hands. Even if a 
larger staff had been provided, it would have been impossible to give 
much time to a single patient, for numerous patients mighl lie 
brought in at any moment. During the battle therefore urgent and 
temporary measures only, could lie taken, and on the evening when 
the engagement was over, each patient was for the first time properly 
treated according to the nature of his wounds. At this time un- 
doubtedly, the best care possible was taken for the disinfection 
of the wounds ami surrounding parts ; hut as the ordinary process of 
disinfection is. as has been said, insufficient, so the precautions taken 
did nut come up to the degree actually required. Besides, when one 
or two cases of sn pj ii ira i i< m had appeared, circumstances forbade their 



SUPPURATION. 391 

being treated, as in hospitals, with, isolation from other patients ; and 
the condition of the patients before they were admitted to the hospital, 
was not the same on board all ships. 

When it happened on the Matsushima, that a large number of 
persons was wounded at onetime, and the surgeries received damages, 
not a few medical materials being lost, the burn patients were just 
rubbed with vegetable oil used in the engine-room. It is plain that 
here antiseptic precautions were insufficient. With burns, owing to 
the extent of their areas, microorganisms are very likely to intrude not 
only from outside, but also from the skin, and suppuration can often 
not be avoided, even though sufficient antiseptic measures have been 
taken. Accordingly it was quite natural that these wounds should 
suppurate, the precautions taken being so imperfect: indeed most of 
them began to suppurate from the very beginning. , Also, the dress- 
ing of burns requires much time, and the surgeons and nurses were too 
busy to give adequate treatment to other patients ; so the ship having 
been otherwise disabled, Avas sent back to Sasebo where the wounded 
persons were admitted to the hospital. This was after the lapse of 
three days and nights spent in the voyage, etc, and by that time the 
wounds were found already suppurating. 

On the Hivei, all the surgeons were killed, and all the nurses 
either killed or wounded, the medical materials were lost, and the 
wounded men could not properly be treated until the ship returned to 
the temporary rendezvous next day. Here at last they received for 
the first time ti - eatment from surgeons, but they had to lie transferred 
to another ship before proper treatment could be given because the ship 
bad to hasten back in order to rejoin the fleet. Suppuration could 
not be avoided. The other ships cruised about in search of hostile 
vessels, on the day following the battle, and came back to the tern- 



392 SUPPURATION. 

porary station on the 3rd day. Here the wounded men were trans- 
ferred to the transport Genkai-maru and sent back to Sasebd together 
with the men from the Hiyei. They numbered 66 in all. The 
Genkai-maru was not originally provided for transporting so m;my 
serious patients, but unfortunately the hospital ship prepared to meel 
such emergencies happened to be a long way off, and they had to 
avail themselves of the Genkai-maru. The ship had not sufficienl 
room for the patients to lie down in, there was only one surgeon 
attached, and though four nurses from other ships were put on board 
the ship for temporary assistance, they had not a sufficient supply of 
surgical instruments and dressings and experienced no small difficulty 
iii treating 66 serious cases, when even the simple precaution of isolat- 
ing patients with suppurating wounds was impossible. The surgeons 
and nurses worked day and night, but they were short handed. This 
was one of the weak spots in our treatment of the wounded. 

In the ha trie of the Yellow sea, owing to the various circumstances 
just stated, it was unavoidable that the treatment of the wounded was 
not quite as satisfactory as had been expected : but as ample provision 
had been made in Sasebo Naval Hospital the treatment after admission 
did not fall very far shorl of the high standard demanded. Though 
there were many patients whose wounds had already been suppurat- 
ing, most of them recovered, only 9 persons succumbing to wounds 
in the hospital. But so many patients arriving at once, the resources 
of the hospital were taxed to their utmost extent, and for the firsl 
three or four days, the surgeons and nurses worked day and night, 
vei from the lack of time and hat ids. some wounds as the penetrating 
ones of the abdomen, which mighl have been benefitted if an operation 
had been performed at once, werelefl until it was too late. 

In the attack of Wei-hai-wei, the number of the wounded on 



GA.XGBEXE. 393 

each vessel was very small, and as fortunately, the hospital ship was 
near, they were immediately placed under treatment, but notwith- 
standing this, among the serious cases many wounds suppurated. 
\fy e must attribute this to the character of the injuries, and to the 
difficulty found in keeping a wound from the beginning perfectly 
clean, which proves that it is necessary to exercise still greater precau- 
tion in the treatment of wounds in question. 

4.-GANGRENE. 

It was mentioned in the last chapter that tissues around the 
wounds sloughed in very many cases, bu1 those in which distant 
gangrene ensued were seen only in the following instances. The first 
was No. 270 clinical history, which was an injury caused by iron- 
pieces: a contused wound sustained on the front part of the lower 
end of the left thigh, in which though the patella and the lower end 
of the femur were comminuted, yet haemorrhage was not heavy. On 
the next day, when resection of the knee joint was performed, no 
injury was recognised in the popliteal artery, yet at the time when 
the patienl was admitted into the hospital, the circulation below the 
knee-joint was found to be arrested, the end of the foot already chang- 
ed into a purplish colour, showing that the part had mortified. 
Accordingly, amputation was performed a1 the lower third of the 
thigh and the wound afterwards healed. The second was No. 288 
clinical history : a case of a perforating wound caused by a shell-frag- 
raent at the upper part of the right leg, the tibia and fibula being 
heavily comminuted so as to open the knee-joint, accompanied by 
several wounds with loss of substance at the lower third of the thigh 
on the same side. The distal end of the foot began to present signs 



394 GAXGREXE. 

of mortification, and accordingly the thigh was amputated at the lower 
part, on board the Grenkai-maru, but as this patienl had sustained, 
besides those above stated, various serious injuries over tin- whole 
body, being struck by the explosion of an enormous shell, he suc- 
cumbed to the wound a little time after the operation. Whether in 
this case the popliteal artery was completely or partially rent, or was 
heavily contused so as to produce emboli, we can not of course judge 
with certainty, for all the surgeons being killed at the time there was 
none who could tell about the condition of the haemorrhage, but con- 
sidering that the bones were greatly comminuted, we may reasonably 
conclude that the artery was rent completely. On the contrary, with 
the first ease, haemorrhage was slight at the time of injury, and no 
harm was recognised in the popliteal artery when operation was per- 
formed : the iron-fragment hitting the part from the front, broke the 
bone without entering into the joint, so owing to the comminution of 
the lower part of the femur, the popliteal artery which runs closely to 
it was probably heavily contused, so rhar emboli was produced by 
degrees. Also, the front part of the knee hang smashed by a con- 
tused wound, collateral circulation was mostly stopped, and for these 
reasons, probably gangrene sooner set in. There was a case which 
resembles the present one. hut was healed without gangrene, that is 
No. 271 clinical history, in this ease, a large contused wound was 
sustained in front of the right knee-joint, part of the patella smashed 
and the joint opened, but as the lower end of the femur received no 
injury, the artery seemed to have escaped harm. Next, ease No. 224 
clinical history, received a contused lacerated wound attended with 
fracture below the left elbow joint, thus tearing the bifurcation of the 
brachial artery, the patient also sustained a blind wound on the upper 
arm of the same side. When first examined in the hospital, the part 



ERYSIPELAS. 395 

below the forearm was found already gangrenous. Besides those 
above mentioned, No. 304 clinical history, received a contused wound 
attended with fracture on the left toes, the tips of which became 
gangrenous. This however, can not he numbered as an instance of 
distant gangrene. As the shell-wound compared with the Indict 
wound is much more serious, the former is more liable to gangrene. 
In the late war, of 25(> wounded persons, instances of distant gang- 
rene are three above stated, and each of them was caused by a main 
artery being injured together with more or less collateral branches ; 

in these cases gangrene Avas an inevitable result. Again with shell- 
ed c^ o 

wounds, sometimes a local gangrene occurs in the skin inflicted with 
contusion where at first no injuries were seen, vet after a. time, a large 
slough is produced. But then- was no such case in the late war. 
neither any gangrene so common in former wars and known by the 
name of inflammatory or septic, or hospital gangrenes. 

5.-ERYSIPELAS. 

The only traumatic infection occurred among the wounded men 
in the late war was erysipelas. The first was case No. 190 ; this pa- 
tient received a blind wound below tin 1 spine of the right scapula on 
September 17th, and on October 12th, while he was in the Susebo 
Naval Hospital, he was attacked by erysipelas, but fortunately being 
a. slight case, it was cured on the 22nd following. The second was 
case No. 270, which owing to the gangrene of the left lower limb had. 
on September 22nd, the thigh amputated at the lower third, and 
when, on January 31st the next year, the stump was about to heal, 
erysipelas attacked him in the Kure hospital, but as it was a slighl 
case, he recovered before long. The third one was case Xo. 192, 



396 ERYSIPELAS. 

which \v:is a patient with a perforating wound attended with fracture, 
extending from the right scapula to the upper arm. Bealing of the 
wound was much delayed and on February 27th the following year, 
temperature suddenly rose to over 4(1° ; the skin around the wound 
orifice became inflamed. In spite of all possible treatment, the inflam- 
mation gradually spread and the genera] strength failing day after 
day, he unfortunately succumbed to it on March 17th. It is true 
erysipelas developed in three out of 256 wounded, bu1 they were all 
idiopathic and have no trace of infection to each other. There were 
numerous serious wounds, a large number of which, for reasons 
already stated, fell into suppui'ation, and healing proved very difficult, 
requiring a gi'eat ninny days of treatment in the hospitals, also ;i 
large number of surgical cases besides those wounded in buttle were 
admitted, these fiefs combined made the hospitals overcrowded and 
would have led to development of erysipelas. 



CHPTEE VI 

MANAGEMENT OF THE WOUNDED. 

1 -SURGERY IN THE SHIP. 

The surgery of si ship ought to be conveniently placed for collect- 
ing the wounded from the various parts of the ship, and also in places 
least liable to be disturbed by hostile shells. In the men-of-war of 
former days as in the time of Nelson, there was a wide hatch extending 
vertically from the upper deck to the bottom, and below the water line 
which was admirably adapted, being in the centre of the ship, for spa- 
cious surgery — Nowadays this part is occupied by the engine room, 
coal bunks etc., leaving no room for the wounded. This difficulty is 
experienced now in every ship, the surgery must be placed at the lore 
and aft of the ship and consequently two are necessary, for it would 
be inconvenient to convex' the wounded from one end of the ship to 
the other, espeeiallv so when the water-tight doors were closed, neces- 
sitating a very roundabout communication between the fore and alt 
of the ship. But, as in almost all ships, there was no room for a sur- 
gery at the fore or al't below the water-line, therefore places like the 
lower deck were chosen which is above the water-line, and not quite 
free from the intrusion of hostile shells, so it was the general scheme 
that two surgeries one at each end should he established. But some 
ships lacking room, had to he content with only one surgery. The 
Hivei is an instance of this kind, and in the ship as already 
stated, the surgery which was established in the wardroom at 
the rear of the lower deck, was hit by an enormous shell which 



;}98 SURGERY IN THE SHIP. 

killed all the surgeons and others who happened to be there, or 
at least inflicted serious wounds, and also destroyed nearly the 
whole of the surgical instruments &c. In the Matsushima, two 
surgeries were established, one on the upper deck of the fore part, ami 
another on the waist of the lower deck, both were destroyed by shells 
and the explosion of ammunition; and at this time the chief surgeon 
oftheileet was seriously injured, and some of the wounded persons 
then receiving treatment were killed; this caused also a greal loss of 
surgical instruments &c. In the Yoshino, one of the surgeries which 
was placed in the ward-room at the rear of the lower deck, was twice 
struck by hostile shells, hut luckily no one was injured except a nurse 
who sustained a slighl wound. We see therefore that any part that 
is above the water-line, is not ivrr from the danger of being struck by 
shells and is of course unfitted for a surgery ; but in the absence of 
room below the line, there is no alternative hut to he content with 
what is obtainable. In order therefore to facilitate the conveyance of 
the wounded, and avoid a wholesale catastrophe like that experienced 
in the Hiyei, it is prudent to have two surgeries, hut this division has 
also its disadvantage lor dividing the surgeons, nurses, and surgical 
implements that are anyhow limited in number and quantity in every 
ship, affords much inconvenience in treating many wounded men at 
the same time. In naval hat ties, sometimes fifty or sixty are wounded 
at a time and in one place. Supposing this should occur in the fore 
part of a ship, tin' wounded will naturally he brought to the surgery in 
thai Quarter ; and the surgery is suddenly overfull ami short handed ; 
although only urgeni measures of relief are taken during the fight, ye 1 
even then it is impossible to pay proper attention to all the wounded. 

At the same time, the medical attendants in the other surgery may 
have nothing to do. ami yet they are not a hie to hell i each other which 



SURGERY IX THE SHIP. 399 

is a hindrance to successful treatment. For instance, the treatment of 
the wounded man (No. 1 !•"> clinical history) discussed in the chapter 
on haemorrhage, where haemorrhage was recognised to be heavy at first. 
If there had been then only one surgery and consequently two sur- 
geons in it. one of them probably would have had time enough to 
enlarge the wound orifice, remove the pieces of smashed bone, and 
examining the condition of the artery to apply a ligature to ir. But 
the surgeons being separated, one of them could not spare much time 
to a single patient, and accordingly such an insufficient method as 
applying a compress to the wound orifice was resorted to. 
The fact that main- other wounds afterwards suppurated, was pro- 
bably greatly due to the impossibility of giving any thing more 
than temporary relief at the first. This separating of the surgeries 
may be unavoidable, but it is necessarily attended with greal 
drawbacks; if a single surgerj could be placed in the middle 
of the ship where persons wounded at varrious, parts could con- 
veniently be collected, and at a place below the water-line leasl 
exposed to the danger from shells, it might then be called a suitable 
one. As was already discussed in the last chapter, the character of 
wounds, and conditions in ships during the battle, -were all so un- 
favorable that unless managed most carefully and strictly, the wound- 
could hardly escape suppuration, and even the whole of the medical 
attendants in one place would uol have proved sufficient, then-fore. 
the disadvantage of dividing them is too obvious to need further argu- 
ment. Places appropriated for a surgery or surgeries in respective 
ships are as follows : — 

The Yoshino — Starboard side in the fore part 011 the lower deck ; and the ward- 
room, iu the after part on the lower deck. 

The Naniwa — Ward-room, in the after part on the lower deck. 



JOO SURGERY TN" THE SHIP. 

The Takacbilio — In tlie fore part on the lower deck ; and the wardroom, on the 

lower deck. 

The Akitsushima — In the fore part on the lower deck. 

The Matsushima— Sick berth in the tore part on the upper deck ; and the mess- 
room in the waist of the lower deck. 

The Itsuknshima — Sick berth in the fore part on the lower deck ; the gun-room 
in the waist on the lower deck : and the reception room in the after part on the 
upper dee!;. 

The Hashidate — The store-room in the fore part (below the water-line) ; the 
warrant officers' room in the waist on the lower deck. 

Tin' l'uso — The warrant officers' room in the fore part, (below the water-line) ; 
and by the engine-room in the aft (below the water-line). 

The Chiyoda — in the waist on the lower deck ; and the ward-room on the lower 
deck. 

The Takao — The stokers' room in the fore part on the lower deck ; anil ward- 
room. 

The Kongo — In the tore part on the lower deck ; and the gun-room in the alt. 

The Hiyei — Ward-room in the aft on the lower deck'. 

The Tsukushi — In the fore and after parts on the lower deck. 

The Oshima — The cabin in the aft on the lower deck. 

The Akagi — The cabin, in the aft on the lower deck. 

The Chokai — In front of dispensary in the fore part on the lower deck. 

The AtagO — In the fore part on the lower deck'. 

The Maya — The cabin in the aft on the lower deck. 

The Tenryu — In tin' fore part on the lower deck; and the cock-pit in the aft 
(below the water-line). 

The Kaimon — Ward-room in the alt on the lower deck. 

The Musashi — Sail room in the fore part under the lower deck (below the 
water-line) ,- and the ward-room. 

The Katsuragi — Carpenter's store in the fore part (below the water-line); and 
the after cock-pit (below the water-line). 

The Yamato fore part on the lower deck: and the ward-room. 

The Amagi -In front of dispensary in the lore part on the lower deck. 

The Banjo In front of dispensary in the tore part on the lower deck. 



SURGERY IN THE SHIP. 401 

The Tsnknba — Fore part on the lower deck ; and the ward-room. 
The Yayeyama — Ward-room in the aft on the lower deck. 
The Saikyo-maru — Fore part on the main deck. 

As above stated, places appropriated by the respective ships were 
not the same, and some parts although dirty and narrow and quite 
unfit for surgery, were made use of, as there were no better places. 
This was an unavoidable outcome from the construction of certain 
ships, but considered from a surgical point of view, it must be regard- 
ed as a gross defect. In ships with three surgeons a question may 
arise, how they should be allotted to two surgeries, whether the 
larger number be advantageously placed in the fore part or in the 
aft. This must be determined according to the size of the respective 
surgeries, and their convenience for the collection of the wounded. 
However, as is plain from the 6th and loth tables in chapter in, the 
comparative numbers of the wounded in the fore and the aft are any- 
thing but certain, as might be expected. That the total number of 
the wounded in the fore part was by far larger than that of the aft, 
was because a large number happened to be wounded in the fore part 
of the Matsushima. 

2.-C0NVEYANCE OF THE WOUNDED. 

Apparatus for the conveyance of the wounded can no more be 
uniform in size and construction than ships can. Various kinds had 
been provided for use on board, one like an easy-chair, net hammock 
Macdonald's or Gihon's stretchers, etc., and the men had been drilled 
beforehand in their use. But during- the actual engagement, it was 
found that stretchers of all kinds were cumbrous and troublesome, 
and of very little use for the speedy conveyance of a large number of 



402 CONVEYANCE OF THE WOUXDED. 

wounded to the surgeries, during the noise and confusion of the battle. 

Hands alone were therefore employed on board the ships, and the 
stretchers were laid aside. Conveyance by hands alone, is prompt 
and convenient, even if there be many wounded persons at one time ; 
for every man that is uninjured ran generally he useful for carrying 
wounded men ; and so during the actual battle, our men were oblig- 
ed to resort to this method. But even then a seriously wounded 
person, requires the assistance of 3 or 4 men. to get him up or down 
stairs, and there is always a great deal of confusion in the removal ; 
also, in the conveyance of patients who have sustained fracture or 
extensive burns, this method certainly aggravates the injury ; and, 
from this point of view, carrying on stretchers is Itv far the better. 
We have still a great deal to learn about the conveyance of the 
wounded on ships, hut it is a sine ma non that some handy way like 
the hare hand method must be resorted to. at the time of actual 
engagement, and therefore ships' crews should he also drilled in this 
method of conveyance. 

After the battle, in transferring the wounded from one ship to 
•another, and similar cases, the bare-hand method is not needed ; for 
the wounds have by this time been properly treated : splints and hand- 
ages have been applied; and there is time enough to lay the patients 
comfortably upon stretchers. On such occasions, held and other stret- 
chers on which the wounded person could lie full length were made 
use of; the patients were let down by means of pulleys and sent out 
through hatches or port-holes, without the slightest hitch. 

3.- TREATMENT OF THE WOUNDED. 
In regard to the treatment of the wounded, we have already 

stated, that at first onlv urgent and temporary measures of relict were 



TREATMENT OF THE WOUNDED. 433 

taken, such as to wash the insides of the wounds, to disinfect the sur- 
rounding skin, to extract foreign bodies when they could be easily 
seen and removed, to staunch haemorrhage, by compression or torsion, 
and in case of a fracture to apply splints. This is inevitable during 
battle, when little individual care can be given to the patients : when 
the battle was over, proper treatment was accorded in the order of the 
urgency of the respective wounds. At the time of the second treat- 
ment, the wounds were again disinfected within and around, any 
foreign body that was recognised by exploration was removed, splints 
that were found not to have been properly applied were renewed, and 
so forth. The battle of the Yellow sea. was not however, finished 
before night fad : the darkness combined with the utter exhaustion 
of the crews, made the subsequent treatment extremely difficult. The 
principal antiseptics used in ships for irrigation of wounds and other 
similar purposes, was a solution of carbolic acid, 2.5 — 3 per cent, 
sometimes supplemented by a sprinkling of iodoform. To wounds 
in the eyes, chest and abdomen, a solution of boracic acid 
was chiefly used. For dressing materials, corrosive sublimate 
gauze, carbolic acid gauze or absorbent cotton wool were em- 
ployed, witli linseed oil paper and bandagd applied over them. The 
splints used were all made of wood. For gypsum bandage, which is 
very inconvenient for use on ships during action, wooden splints 
proved an efficacious substitute. As notwithstanding the great at- 
tention paid on each ship to the washing of wounds with antiseptic 
solution, the process was, as was said in the last chapter, not enough 
to prevent the wounds from suppuration, it is plain that stronger mea- 
sures should be taken with shell-wounds. It is true that shell-wounds 
are extremelv disposed to suppuration, that the conditions on hoard 
ships during action were likely to soil wounds ; and besides, the 



404 TREATMENT OF THE WOUNDED. 

surgeries were all in unsuitable locations. These were unavoidable 
circumstances, but there are still other points to which further atten- 
tion should be called. With shell-wounds .sustained in parts covered 
with clothes, a soiled piece of cloth, is very frequently found remain- 
ing' within, and there were not a few r cases in which these foreign sub- 
stances were taken out in the hospital, to which the patients were ad- 
mitted many days after injury. This must have been one of the causes 
which promoted suppuration, and great care should be taken to ex- 
amine the wounds well with the finger lest such foreign substances be 
left behind; for as the inside of the wounds is very irregular, the cloth 
pieces can not be washed out by mere irrigation with an antiseptic so- 
lution. Again, we have seen that, on account of the loss of vital func- 
tion, the wound surface can not resist even a few micro-organisms, if 
(.nee admitted. The surrounding tissues should therefore be strictly dis- 
infected, care being taken at the same time that the disinfection should 
cover :i larger area than that which is protected by dressing materials. 
The inside of the wound can not be expected to be perfectly 
cleansed during the confusion of fighting, so if the quantity required 
be not so large as to cause poisoning, a solid antiseptic like iodoform 
may conveniently be sprinkled into the wound. Next, materials for 
dressing may be preserved with care, hut as many days must necessari- 
ly elapse before they are actually used, and as their absolute purity can 
not be assured, there is a need of having on each ship some handy 
apparatus for disinfecting them immediately before use. It is a fad 
too well known to need mentioning here, thai every thing thai touches 
the wound should be clean; still it is well to insist on it once, for tear it 
should be neglected in the confusion of future actions. The greatesl 
difficulty that was experienced in the way of treatment, was the 
managemenl of patients suffering from extensive burns over the body. 



'JREATMENT OF THE WOUNDED. 495 

Not tn mention that much time was required in changing the dressings, 

i In' sufferings of patients while being washed with antiseptic solution 
were extreme. Lastly, on one ship, it happened that owing to the loss 
of surgical dressings dec., and the consequently insufficient application 
of antiseptics, the burns soon suppurated. This is another point on 
which we have to pursue further investigations. The chief antiseptic 
that was used in the hospitals, was a solution of carbolic acid, some- 
times of corrosive sublimate, and of boracic acid, also iodoform in a very 
few instances. The dressings were made to be always sterilized before 
use. and at the same time great care was taken with antiseptic precau- 
tions, vet it was nut an easy matter to eradicate the suppuration of 
the wound, ami consequently the course of the wounds was general- 
ly slow, and a comparatively large number of days was required for 
treatment. As was shown by No. -1 table in chapter III, the number 
of days' sickness was 15,880 for 254 wounded persons, which is the 
total of the days' sickness both on ships and in hospitals. This gives 
a ratio of C>2i days for each wounded man. [f 27 patients who died 
from serious wounds within .'> days after injury, and 17 patients who 
were cured within ."> days as their wounds were slight, !«■ subtracted, 
and the days of sickness for the remainder be counted, the average for 
each patient will heroine 24 months which shows that the number of 
days' sickness was strikingly high in the late war. This is because the 
nature of a shell-wound is different from that of other wounds and is 
very hard to cure. Ten soldiers from the army who had received 
bullet wounds in the Pescadores were admitted to the Sasebo Naval 
Hospital, ami we treated them in exactly the same way as the other 
patients, and took the opportunity of comparing the respective cura- 
bility, of bullet and shell wounds. We found that there was a 
striking difference between the two, even when the wounds were quite 



406 TREATMENT OF THE WOUNDED. 

alike in their outward appearances. In the hospitals, we resoi'ted to 
the conservative surgery as much as we could: amputation or 
resection for compound fractures or injuries to the joints was 
avoided whenever possible : and this treatment was mostly at- 
tended with favorable' insults. The only cases in which amputa- 
tion was performed were 3 : — No. 270 clinical history, in which 
ilif lower parr of the left thigh was amputated; No. 22 [, for which 
amputation of the middle part of the left arm was performed, and No. 
261, in which the upper part of the right thigh was amputated. The 
lasi of these died after operation. Fur the lotion of burns, solutions of 
carbolic acid and boracic acid were employed; sometimes powders or 
ointments of boracic acid, iodoform and salicylic acid ; but it was 
found extremely difficult to keep the wounded parts clean. Great 
pain was complained of at the time of changing the dressings, which 
were accordingly renewed as rarely as possible. Ihit as it happened 
to be the hottest season of the year, maggots were frequently produced 
under the dressings, which had then necessarily to he renewed pretty 
often in spite of the pain. With the purpose of preventing the stick- 
ing of dressings to the burned surface, the part was tirst washed, 
then fenestrated oiled paper was placed on it. with gauze or cot ton wool 
put over it. Hut this proved to be unsatisfactory, For the discharge 
would accumulate under the oiled paper. 



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Accession no. 30635 

syoshi, Yasuzu- 
Author 

cal 
history . . . 
„ „ Hist 

Call no. 

19 






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